Pathological Changes in the Lungs of Patients with a Lethal COVID-19 Clinical Course

The novel coronavirus SARS-CoV-2 was identified in 2019 and quickly became the cause of the fifth worst pandemic in human history. Our goal for this research paper was to examine the morphology of the lungs in 88 patients that died from COVID-19 in Latvia, thus increasing the data available about th...

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Main Authors: Valters Viksne, Ilze Strumfa, Maris Sperga, Janis Ziemelis, Juris Abolins
Format: Article
Language:English
Published: MDPI AG 2022-11-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/12/11/2808
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author Valters Viksne
Ilze Strumfa
Maris Sperga
Janis Ziemelis
Juris Abolins
author_facet Valters Viksne
Ilze Strumfa
Maris Sperga
Janis Ziemelis
Juris Abolins
author_sort Valters Viksne
collection DOAJ
description The novel coronavirus SARS-CoV-2 was identified in 2019 and quickly became the cause of the fifth worst pandemic in human history. Our goal for this research paper was to examine the morphology of the lungs in 88 patients that died from COVID-19 in Latvia, thus increasing the data available about the histological characteristics of SARS-CoV-2-induced disease. Lung tissue samples from 88 autopsies were visualized in hematoxylin–eosin and assessed by light microscopy. The male-to-female ratio was 56:32, and the mean age was 62 years ± 15.5 years (22–94 years). Clinically important laboratory data were assessed, including leucocyte count, CRP (C-reactive protein) and D-dimer levels. Signs of diffuse alveolar damage were found in 83/88 (94.3%; 95% CI 87.0–97.9) of patients, 38/88 (43.2%; 95% CI 33.3–53.6) in the exudative phase, and 45/88 (51.1%; 95% CI 40.8–61.3) in the proliferative phase. Vascular damage was identified in 70/88 (79.5%; 95% CI 69.9–86.7) of patients, and 83/88 (94.3%; 95% CI 87.0–97.9) had signs of thrombosis. A sparse inflammatory infiltrate of lymphocytes and macrophages was a common finding aside from cases with an identified coinfection. Eighty patients had significant co-morbidities, including coronary heart disease (49), primary arterial hypertension (41), and diabetes mellitus (34). Since our group’s demographic profile and spectrum of co-morbidities were analogous to other reports, the histological findings of marked diffuse alveolar damage, widespread vascular lesions, and active thrombosis can be considered representative of severe COVID-19.
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spelling doaj.art-5be2a46507ec4fe089a36af30dfd43f02023-11-24T08:04:37ZengMDPI AGDiagnostics2075-44182022-11-011211280810.3390/diagnostics12112808Pathological Changes in the Lungs of Patients with a Lethal COVID-19 Clinical CourseValters Viksne0Ilze Strumfa1Maris Sperga2Janis Ziemelis3Juris Abolins4Pathology Center, Riga East Clinical University Hospital “Gaiļezers”, Hipokrata Street 2, LV-1038 Riga, LatviaDepartment of Pathology, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, LatviaPathology Center, Riga East Clinical University Hospital “Gaiļezers”, Hipokrata Street 2, LV-1038 Riga, LatviaPathology Center, Riga East Clinical University Hospital “Gaiļezers”, Hipokrata Street 2, LV-1038 Riga, LatviaPathology Center, Riga East Clinical University Hospital “Gaiļezers”, Hipokrata Street 2, LV-1038 Riga, LatviaThe novel coronavirus SARS-CoV-2 was identified in 2019 and quickly became the cause of the fifth worst pandemic in human history. Our goal for this research paper was to examine the morphology of the lungs in 88 patients that died from COVID-19 in Latvia, thus increasing the data available about the histological characteristics of SARS-CoV-2-induced disease. Lung tissue samples from 88 autopsies were visualized in hematoxylin–eosin and assessed by light microscopy. The male-to-female ratio was 56:32, and the mean age was 62 years ± 15.5 years (22–94 years). Clinically important laboratory data were assessed, including leucocyte count, CRP (C-reactive protein) and D-dimer levels. Signs of diffuse alveolar damage were found in 83/88 (94.3%; 95% CI 87.0–97.9) of patients, 38/88 (43.2%; 95% CI 33.3–53.6) in the exudative phase, and 45/88 (51.1%; 95% CI 40.8–61.3) in the proliferative phase. Vascular damage was identified in 70/88 (79.5%; 95% CI 69.9–86.7) of patients, and 83/88 (94.3%; 95% CI 87.0–97.9) had signs of thrombosis. A sparse inflammatory infiltrate of lymphocytes and macrophages was a common finding aside from cases with an identified coinfection. Eighty patients had significant co-morbidities, including coronary heart disease (49), primary arterial hypertension (41), and diabetes mellitus (34). Since our group’s demographic profile and spectrum of co-morbidities were analogous to other reports, the histological findings of marked diffuse alveolar damage, widespread vascular lesions, and active thrombosis can be considered representative of severe COVID-19.https://www.mdpi.com/2075-4418/12/11/2808COVID-19diffuse alveolar damageautopsyhistologythrombosislung infarction
spellingShingle Valters Viksne
Ilze Strumfa
Maris Sperga
Janis Ziemelis
Juris Abolins
Pathological Changes in the Lungs of Patients with a Lethal COVID-19 Clinical Course
Diagnostics
COVID-19
diffuse alveolar damage
autopsy
histology
thrombosis
lung infarction
title Pathological Changes in the Lungs of Patients with a Lethal COVID-19 Clinical Course
title_full Pathological Changes in the Lungs of Patients with a Lethal COVID-19 Clinical Course
title_fullStr Pathological Changes in the Lungs of Patients with a Lethal COVID-19 Clinical Course
title_full_unstemmed Pathological Changes in the Lungs of Patients with a Lethal COVID-19 Clinical Course
title_short Pathological Changes in the Lungs of Patients with a Lethal COVID-19 Clinical Course
title_sort pathological changes in the lungs of patients with a lethal covid 19 clinical course
topic COVID-19
diffuse alveolar damage
autopsy
histology
thrombosis
lung infarction
url https://www.mdpi.com/2075-4418/12/11/2808
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AT janisziemelis pathologicalchangesinthelungsofpatientswithalethalcovid19clinicalcourse
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