More than Pneumonia: Distinctive Features of SARS-Cov-2 Infection. From Autopsy Findings to Clinical Implications: A Systematic Review
Despite safety recommendations for the management of corpses with COVID-19 infection and the high number of deaths worldwide, the post-mortem investigation rate is extremely low as well as the scientific contributions describing the pathological features. The first results of post-mortem investigati...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-10-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/8/11/1642 |
| _version_ | 1797550009268305920 |
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| author | Stefano D’Errico Martina Zanon Martina Montanaro Davide Radaelli Francesco Sessa Giulio Di Mizio Angelo Montana Salvatore Corrao Monica Salerno Cristoforo Pomara |
| author_facet | Stefano D’Errico Martina Zanon Martina Montanaro Davide Radaelli Francesco Sessa Giulio Di Mizio Angelo Montana Salvatore Corrao Monica Salerno Cristoforo Pomara |
| author_sort | Stefano D’Errico |
| collection | DOAJ |
| description | Despite safety recommendations for the management of corpses with COVID-19 infection and the high number of deaths worldwide, the post-mortem investigation rate is extremely low as well as the scientific contributions describing the pathological features. The first results of post-mortem investigations provided interesting findings and contributed to promoting unexplored therapeutic approaches and new frontiers of research. A systematic review is provided with the aim of summarizing all autopsy studies up to February 2020 in which a complete post-mortem investigation in patients with COVID-19 disease was performed, focusing on histopathological features. We included case reports, case series, retrospective and prospective studies, letters to the editor, and reviews. A total of 28 studies fulfilled the inclusion criteria, producing a pooled dataset of 407 full autopsies. Analyzing the medical history data, only 12 subjects had died without any comorbidities (for 15 cases the data were not available). The post-mortem investigation highlighted that acute respiratory distress syndrome (ARDS) and multiple organ failure represent the main clinical features of COVID-19 disease, often leading to pulmonary thromboembolism and superimposed bronchopneumonia. The discussed data showed a strict relationship among the inflammatory processes, diffuse alveolar, and endothelial damage. In light of these results, the full autopsy can be considered as the gold standard to investigate unknown infections or pathogens resulting in death. |
| first_indexed | 2024-03-10T15:23:20Z |
| format | Article |
| id | doaj.art-22a1e4a41e814f0d98998073db8ab69c |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-10T15:23:20Z |
| publishDate | 2020-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-22a1e4a41e814f0d98998073db8ab69c2023-11-20T18:16:59ZengMDPI AGMicroorganisms2076-26072020-10-01811164210.3390/microorganisms8111642More than Pneumonia: Distinctive Features of SARS-Cov-2 Infection. From Autopsy Findings to Clinical Implications: A Systematic ReviewStefano D’Errico0Martina Zanon1Martina Montanaro2Davide Radaelli3Francesco Sessa4Giulio Di Mizio5Angelo Montana6Salvatore Corrao7Monica Salerno8Cristoforo Pomara9Department of Medical, Surgical and Health, University of Trieste, 34121 Trieste, ItalyDepartment of Medical, Surgical and Health, University of Trieste, 34121 Trieste, ItalyDepartment of Medical, Surgical and Health, University of Trieste, 34121 Trieste, ItalyDepartment of Medical, Surgical and Health, University of Trieste, 34121 Trieste, ItalyDepartment of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, ItalyDepartment of Law, Forensic Medicine, Magna Graecia University of Catanzaro, 88100 Catanzaro, ItalyDepartment of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, ItalyDepartment of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina and Benfratelli, 90100 Palermo, ItalyDepartment of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, ItalyDepartment of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, ItalyDespite safety recommendations for the management of corpses with COVID-19 infection and the high number of deaths worldwide, the post-mortem investigation rate is extremely low as well as the scientific contributions describing the pathological features. The first results of post-mortem investigations provided interesting findings and contributed to promoting unexplored therapeutic approaches and new frontiers of research. A systematic review is provided with the aim of summarizing all autopsy studies up to February 2020 in which a complete post-mortem investigation in patients with COVID-19 disease was performed, focusing on histopathological features. We included case reports, case series, retrospective and prospective studies, letters to the editor, and reviews. A total of 28 studies fulfilled the inclusion criteria, producing a pooled dataset of 407 full autopsies. Analyzing the medical history data, only 12 subjects had died without any comorbidities (for 15 cases the data were not available). The post-mortem investigation highlighted that acute respiratory distress syndrome (ARDS) and multiple organ failure represent the main clinical features of COVID-19 disease, often leading to pulmonary thromboembolism and superimposed bronchopneumonia. The discussed data showed a strict relationship among the inflammatory processes, diffuse alveolar, and endothelial damage. In light of these results, the full autopsy can be considered as the gold standard to investigate unknown infections or pathogens resulting in death.https://www.mdpi.com/2076-2607/8/11/1642COVID-19autopsydiffuse alveolar damage (DAD)acute respiratory distress syndrome (ARDS)microthrombosisacute kidney injury (AKI) |
| spellingShingle | Stefano D’Errico Martina Zanon Martina Montanaro Davide Radaelli Francesco Sessa Giulio Di Mizio Angelo Montana Salvatore Corrao Monica Salerno Cristoforo Pomara More than Pneumonia: Distinctive Features of SARS-Cov-2 Infection. From Autopsy Findings to Clinical Implications: A Systematic Review Microorganisms COVID-19 autopsy diffuse alveolar damage (DAD) acute respiratory distress syndrome (ARDS) microthrombosis acute kidney injury (AKI) |
| title | More than Pneumonia: Distinctive Features of SARS-Cov-2 Infection. From Autopsy Findings to Clinical Implications: A Systematic Review |
| title_full | More than Pneumonia: Distinctive Features of SARS-Cov-2 Infection. From Autopsy Findings to Clinical Implications: A Systematic Review |
| title_fullStr | More than Pneumonia: Distinctive Features of SARS-Cov-2 Infection. From Autopsy Findings to Clinical Implications: A Systematic Review |
| title_full_unstemmed | More than Pneumonia: Distinctive Features of SARS-Cov-2 Infection. From Autopsy Findings to Clinical Implications: A Systematic Review |
| title_short | More than Pneumonia: Distinctive Features of SARS-Cov-2 Infection. From Autopsy Findings to Clinical Implications: A Systematic Review |
| title_sort | more than pneumonia distinctive features of sars cov 2 infection from autopsy findings to clinical implications a systematic review |
| topic | COVID-19 autopsy diffuse alveolar damage (DAD) acute respiratory distress syndrome (ARDS) microthrombosis acute kidney injury (AKI) |
| url | https://www.mdpi.com/2076-2607/8/11/1642 |
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