A Systematic Review of Lung Autopsy Findings in Elderly Patients after SARS-CoV-2 Infection
Although COVID-19 may cause various and multiorgan diseases, few research studies have examined the postmortem pathological findings of SARS-CoV-2-infected individuals who died. Active autopsy results may be crucial for understanding how COVID-19 infection operates and preventing severe effects. In...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/5/2070 |
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| author | Susa Septimiu-Radu Tejaswi Gadela Doros Gabriela Cristian Oancea Ovidiu Rosca Voichita Elena Lazureanu Roxana Manuela Fericean Felix Bratosin Andreea Dumitrescu Emil Robert Stoicescu Iulia Bagiu Mircea Murariu Adelina Mavrea |
| author_facet | Susa Septimiu-Radu Tejaswi Gadela Doros Gabriela Cristian Oancea Ovidiu Rosca Voichita Elena Lazureanu Roxana Manuela Fericean Felix Bratosin Andreea Dumitrescu Emil Robert Stoicescu Iulia Bagiu Mircea Murariu Adelina Mavrea |
| author_sort | Susa Septimiu-Radu |
| collection | DOAJ |
| description | Although COVID-19 may cause various and multiorgan diseases, few research studies have examined the postmortem pathological findings of SARS-CoV-2-infected individuals who died. Active autopsy results may be crucial for understanding how COVID-19 infection operates and preventing severe effects. In contrast to younger persons, however, the patient’s age, lifestyle, and concomitant comorbidities might alter the morpho-pathological aspects of the damaged lungs. Through a systematic analysis of the available literature until December 2022, we aimed to provide a thorough picture of the histopathological characteristics of the lungs in patients older than 70 years who died of COVID-19. A thorough search was conducted on three electronic databases (PubMed, Scopus, and Web of Science), including 18 studies and a total of 478 autopsies performed. It was observed that the average age of patients was 75.6 years, of which 65.4% were men. COPD was identified in an average of 16.7% of all patients. Autopsy findings indicated significantly heavier lungs, with an average weight of the right lung of 1103 g, while the left lung mass had an average weight of 848 g. Diffuse alveolar damage was a main finding in 67.2% of all autopsies, while pulmonary edema had a prevalence of between 50% and 70%. Thrombosis was also a significant finding, while some studies described focal and extensive pulmonary infarctions in 72.7% of elderly patients. Pneumonia and bronchopneumonia were observed, with a prevalence ranging from 47.6% to 89.5%. Other important findings described in less detail comprise hyaline membranes, the proliferation of pneumocytes and fibroblasts, extensive suppurative bronchopneumonic infiltrates, intra-alveolar edema, thickened alveolar septa, desquamation of pneumocytes, alveolar infiltrates, multinucleated giant cells, and intranuclear inclusion bodies. These findings should be corroborated with children’s and adults’ autopsies. Postmortem examination as a technique for studying the microscopic and macroscopic features of the lungs might lead to a better knowledge of COVID-19 pathogenesis, diagnosis, and treatment, hence enhancing elderly patient care. |
| first_indexed | 2024-03-11T07:19:42Z |
| format | Article |
| id | doaj.art-86dcc20940734279b3cc69e1a0dc7d1c |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T07:19:42Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-86dcc20940734279b3cc69e1a0dc7d1c2023-11-17T08:02:12ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01125207010.3390/jcm12052070A Systematic Review of Lung Autopsy Findings in Elderly Patients after SARS-CoV-2 InfectionSusa Septimiu-Radu0Tejaswi Gadela1Doros Gabriela2Cristian Oancea3Ovidiu Rosca4Voichita Elena Lazureanu5Roxana Manuela Fericean6Felix Bratosin7Andreea Dumitrescu8Emil Robert Stoicescu9Iulia Bagiu10Mircea Murariu11Adelina Mavrea12Department XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaSchool of General Medicine, Bhaskar Medical College, Amdapur Road 156-162, Hyderabad 500075, IndiaDepartment of Pediatrics, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaCenter for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaDepartment XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaDepartment XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaDepartment XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaDepartment XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaCardioprevent Foundation, Calea Dorobantilor 3, Timisoara 300134, RomaniaDoctoral School, ‘’Victor Babes’’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaDepartment of Microbiology, Multidisciplinary Research Center on Antimicrobial Resistance, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaDoctoral School, ‘’Victor Babes’’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaDepartment of Internal Medicine I, Cardiology Clinic, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaAlthough COVID-19 may cause various and multiorgan diseases, few research studies have examined the postmortem pathological findings of SARS-CoV-2-infected individuals who died. Active autopsy results may be crucial for understanding how COVID-19 infection operates and preventing severe effects. In contrast to younger persons, however, the patient’s age, lifestyle, and concomitant comorbidities might alter the morpho-pathological aspects of the damaged lungs. Through a systematic analysis of the available literature until December 2022, we aimed to provide a thorough picture of the histopathological characteristics of the lungs in patients older than 70 years who died of COVID-19. A thorough search was conducted on three electronic databases (PubMed, Scopus, and Web of Science), including 18 studies and a total of 478 autopsies performed. It was observed that the average age of patients was 75.6 years, of which 65.4% were men. COPD was identified in an average of 16.7% of all patients. Autopsy findings indicated significantly heavier lungs, with an average weight of the right lung of 1103 g, while the left lung mass had an average weight of 848 g. Diffuse alveolar damage was a main finding in 67.2% of all autopsies, while pulmonary edema had a prevalence of between 50% and 70%. Thrombosis was also a significant finding, while some studies described focal and extensive pulmonary infarctions in 72.7% of elderly patients. Pneumonia and bronchopneumonia were observed, with a prevalence ranging from 47.6% to 89.5%. Other important findings described in less detail comprise hyaline membranes, the proliferation of pneumocytes and fibroblasts, extensive suppurative bronchopneumonic infiltrates, intra-alveolar edema, thickened alveolar septa, desquamation of pneumocytes, alveolar infiltrates, multinucleated giant cells, and intranuclear inclusion bodies. These findings should be corroborated with children’s and adults’ autopsies. Postmortem examination as a technique for studying the microscopic and macroscopic features of the lungs might lead to a better knowledge of COVID-19 pathogenesis, diagnosis, and treatment, hence enhancing elderly patient care.https://www.mdpi.com/2077-0383/12/5/2070SARS-CoV-2old ageCOVID-19elderly patientsautopsysevere infection |
| spellingShingle | Susa Septimiu-Radu Tejaswi Gadela Doros Gabriela Cristian Oancea Ovidiu Rosca Voichita Elena Lazureanu Roxana Manuela Fericean Felix Bratosin Andreea Dumitrescu Emil Robert Stoicescu Iulia Bagiu Mircea Murariu Adelina Mavrea A Systematic Review of Lung Autopsy Findings in Elderly Patients after SARS-CoV-2 Infection Journal of Clinical Medicine SARS-CoV-2 old age COVID-19 elderly patients autopsy severe infection |
| title | A Systematic Review of Lung Autopsy Findings in Elderly Patients after SARS-CoV-2 Infection |
| title_full | A Systematic Review of Lung Autopsy Findings in Elderly Patients after SARS-CoV-2 Infection |
| title_fullStr | A Systematic Review of Lung Autopsy Findings in Elderly Patients after SARS-CoV-2 Infection |
| title_full_unstemmed | A Systematic Review of Lung Autopsy Findings in Elderly Patients after SARS-CoV-2 Infection |
| title_short | A Systematic Review of Lung Autopsy Findings in Elderly Patients after SARS-CoV-2 Infection |
| title_sort | systematic review of lung autopsy findings in elderly patients after sars cov 2 infection |
| topic | SARS-CoV-2 old age COVID-19 elderly patients autopsy severe infection |
| url | https://www.mdpi.com/2077-0383/12/5/2070 |
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