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Postmortem Findings in Italian Patients With COVID-19: A Descriptive Full Autopsy Study of Cases With and Without Comorbidities.
J Infect Dis. 2020 11 09; 222(11):1807-1815.JI

Abstract

BACKGROUND

Descriptions of the pathological features of coronavirus disease-2019 (COVID-19) caused by the novel zoonotic pathogen severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emanate from tissue biopsies, case reports, and small postmortem studies restricted to the lung and specific organs. Whole-body autopsy studies of COVID-19 patients have been sparse.

METHODS

To further define the pathology caused by SARS-CoV-2 across all body organs, we performed autopsies on 22 patients with COVID-19 (18 with comorbidities and 4 without comorbidities) who died at the National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS Hospital, Rome, Italy. Tissues from the lung, heart, liver, kidney, spleen, and bone marrow (but not the brain) were examined. Only lung tissues were subject to transmission electron microscopy.

RESULTS

COVID-19 caused multisystem pathology. Pulmonary and cardiovascular involvement were dominant pathological features. Extrapulmonary manifestations included hepatic, kidney, splenic, and bone marrow involvement, and microvascular injury and thrombosis were also detected. These findings were similar in patients with or without preexisting medical comorbidities.

CONCLUSIONS

SARS-CoV-2 infection causes multisystem disease and significant pathology in most organs in patients with and without comorbidities.

Authors+Show Affiliations

National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.Department of Infection, Division of Infection and Immunity, University College London, London, United Kingdom. National Institute for Health Research Biomedical Research Centre, University College London Hospitals National Health Service Foundation Trust, London, United Kingdom.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy. Laboratory of Cellular and Developmental Biology, Department of Biology, University of Rome Tor Vergata, Rome, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32914853

Citation

Falasca, Laura, et al. "Postmortem Findings in Italian Patients With COVID-19: a Descriptive Full Autopsy Study of Cases With and Without Comorbidities." The Journal of Infectious Diseases, vol. 222, no. 11, 2020, pp. 1807-1815.
Falasca L, Nardacci R, Colombo D, et al. Postmortem Findings in Italian Patients With COVID-19: A Descriptive Full Autopsy Study of Cases With and Without Comorbidities. J Infect Dis. 2020;222(11):1807-1815.
Falasca, L., Nardacci, R., Colombo, D., Lalle, E., Di Caro, A., Nicastri, E., Antinori, A., Petrosillo, N., Marchioni, L., Biava, G., D'Offizi, G., Palmieri, F., Goletti, D., Zumla, A., Ippolito, G., Piacentini, M., & Del Nonno, F. (2020). Postmortem Findings in Italian Patients With COVID-19: A Descriptive Full Autopsy Study of Cases With and Without Comorbidities. The Journal of Infectious Diseases, 222(11), 1807-1815. https://doi.org/10.1093/infdis/jiaa578
Falasca L, et al. Postmortem Findings in Italian Patients With COVID-19: a Descriptive Full Autopsy Study of Cases With and Without Comorbidities. J Infect Dis. 2020 11 9;222(11):1807-1815. PubMed PMID: 32914853.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postmortem Findings in Italian Patients With COVID-19: A Descriptive Full Autopsy Study of Cases With and Without Comorbidities. AU - Falasca,Laura, AU - Nardacci,Roberta, AU - Colombo,Daniele, AU - Lalle,Eleonora, AU - Di Caro,Antonino, AU - Nicastri,Emanuele, AU - Antinori,Andrea, AU - Petrosillo,Nicola, AU - Marchioni,Luisa, AU - Biava,Gianluigi, AU - D'Offizi,Gianpiero, AU - Palmieri,Fabrizio, AU - Goletti,Delia, AU - Zumla,Alimuddin, AU - Ippolito,Giuseppe, AU - Piacentini,Mauro, AU - Del Nonno,Franca, PY - 2020/07/20/received PY - 2020/09/08/accepted PY - 2020/9/12/pubmed PY - 2020/12/18/medline PY - 2020/9/11/entrez KW - COVID-19 KW - SARS-CoV-2 KW - autopsy KW - comorbidities KW - pathology SP - 1807 EP - 1815 JF - The Journal of infectious diseases JO - J Infect Dis VL - 222 IS - 11 N2 - BACKGROUND: Descriptions of the pathological features of coronavirus disease-2019 (COVID-19) caused by the novel zoonotic pathogen severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emanate from tissue biopsies, case reports, and small postmortem studies restricted to the lung and specific organs. Whole-body autopsy studies of COVID-19 patients have been sparse. METHODS: To further define the pathology caused by SARS-CoV-2 across all body organs, we performed autopsies on 22 patients with COVID-19 (18 with comorbidities and 4 without comorbidities) who died at the National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS Hospital, Rome, Italy. Tissues from the lung, heart, liver, kidney, spleen, and bone marrow (but not the brain) were examined. Only lung tissues were subject to transmission electron microscopy. RESULTS: COVID-19 caused multisystem pathology. Pulmonary and cardiovascular involvement were dominant pathological features. Extrapulmonary manifestations included hepatic, kidney, splenic, and bone marrow involvement, and microvascular injury and thrombosis were also detected. These findings were similar in patients with or without preexisting medical comorbidities. CONCLUSIONS: SARS-CoV-2 infection causes multisystem disease and significant pathology in most organs in patients with and without comorbidities. SN - 1537-6613 UR - https://www.unboundmedicine.com/medline/citation/32914853/Postmortem_Findings_in_Italian_Patients_With_COVID_19:_A_Descriptive_Full_Autopsy_Study_of_Cases_With_and_Without_Comorbidities_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1093/infdis/jiaa578 DB - PRIME DP - Unbound Medicine ER -