Postmortem Cardiopulmonary Pathology in Patients with COVID-19 Infection: Single-Center Report of 12 Autopsies from Lausanne, Switzerland
We report postmortem cardio-pulmonary findings including detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in formalin-fixed paraffin embedded tissue in 12 patients with COVID-19. The 5 women and 7 men (median age: 73 years; range 35–96) died 6–38 days after onset of symptoms...
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| Language: | English |
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MDPI AG
2021-07-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/8/1357 |
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| author | Sabina Berezowska Karine Lefort Kalliopi Ioannidou Daba-Rokhya Ndiaye Damien Maison Constantinos Petrovas Samuel Rotman Nathalie Piazzon Dina Milowich Nathalie Sala Chun-Yi Tsai Eleonore Multone Pierre-Yves Bochud Mauro Oddo Bettina Bisig Laurence de Leval |
| author_facet | Sabina Berezowska Karine Lefort Kalliopi Ioannidou Daba-Rokhya Ndiaye Damien Maison Constantinos Petrovas Samuel Rotman Nathalie Piazzon Dina Milowich Nathalie Sala Chun-Yi Tsai Eleonore Multone Pierre-Yves Bochud Mauro Oddo Bettina Bisig Laurence de Leval |
| author_sort | Sabina Berezowska |
| collection | DOAJ |
| description | We report postmortem cardio-pulmonary findings including detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in formalin-fixed paraffin embedded tissue in 12 patients with COVID-19. The 5 women and 7 men (median age: 73 years; range 35–96) died 6–38 days after onset of symptoms (median: 14.5 days). Eight patients received mechanical ventilation. Ten patients showed diffuse alveolar damage (DAD), 7 as exudative and 3 as proliferative/organizing DAD. One case presented as acute fibrinous and organizing pneumonia. Seven patients (58%) had acute bronchopneumonia, 1/7 without associated DAD and 1/7 with aspergillosis and necrotic bronchitis. Microthrombi were present in 5 patients, only in exudative DAD. Reverse transcriptase quantitative PCR detected high virus amounts in 6 patients (50%) with exudative DAD and symptom-duration ≤14 days, supported by immunohistochemistry and in-situ RNA hybridization (RNAscope). The 6 patients with low viral copy levels were symptomatic for ≥15 days, comprising all cases with organizing DAD, the patient without DAD and one exudative DAD. We show the high prevalence of DAD as a reaction pattern in COVID-19, the high number of overlying acute bronchopneumonia, and high-level pulmonary virus detection limited to patients who died ≤2 weeks after onset of symptoms, correlating with exudative phase of DAD. |
| first_indexed | 2024-03-10T08:53:50Z |
| format | Article |
| id | doaj.art-a484bda0b5b64bbdac3c38077c86a5c8 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T08:53:50Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-a484bda0b5b64bbdac3c38077c86a5c82023-11-22T07:19:21ZengMDPI AGDiagnostics2075-44182021-07-01118135710.3390/diagnostics11081357Postmortem Cardiopulmonary Pathology in Patients with COVID-19 Infection: Single-Center Report of 12 Autopsies from Lausanne, SwitzerlandSabina Berezowska0Karine Lefort1Kalliopi Ioannidou2Daba-Rokhya Ndiaye3Damien Maison4Constantinos Petrovas5Samuel Rotman6Nathalie Piazzon7Dina Milowich8Nathalie Sala9Chun-Yi Tsai10Eleonore Multone11Pierre-Yves Bochud12Mauro Oddo13Bettina Bisig14Laurence de Leval15Department of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandDepartment of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandDepartment of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandDepartment of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandDepartment of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandDepartment of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandDepartment of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandDepartment of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandDepartment of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandDepartment of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandDepartment of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandDepartment of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandDepartment of Medicine, Service of Infectious Diseases, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, SwitzerlandAdult Intensive Care Medicine Service, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, SwitzerlandDepartment of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandDepartment of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandWe report postmortem cardio-pulmonary findings including detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in formalin-fixed paraffin embedded tissue in 12 patients with COVID-19. The 5 women and 7 men (median age: 73 years; range 35–96) died 6–38 days after onset of symptoms (median: 14.5 days). Eight patients received mechanical ventilation. Ten patients showed diffuse alveolar damage (DAD), 7 as exudative and 3 as proliferative/organizing DAD. One case presented as acute fibrinous and organizing pneumonia. Seven patients (58%) had acute bronchopneumonia, 1/7 without associated DAD and 1/7 with aspergillosis and necrotic bronchitis. Microthrombi were present in 5 patients, only in exudative DAD. Reverse transcriptase quantitative PCR detected high virus amounts in 6 patients (50%) with exudative DAD and symptom-duration ≤14 days, supported by immunohistochemistry and in-situ RNA hybridization (RNAscope). The 6 patients with low viral copy levels were symptomatic for ≥15 days, comprising all cases with organizing DAD, the patient without DAD and one exudative DAD. We show the high prevalence of DAD as a reaction pattern in COVID-19, the high number of overlying acute bronchopneumonia, and high-level pulmonary virus detection limited to patients who died ≤2 weeks after onset of symptoms, correlating with exudative phase of DAD.https://www.mdpi.com/2075-4418/11/8/1357SARS-CoV-2COVID-19diffuse alveolar damageimmunohistochemistryRNAscopereverse transcriptase quantitative PCR |
| spellingShingle | Sabina Berezowska Karine Lefort Kalliopi Ioannidou Daba-Rokhya Ndiaye Damien Maison Constantinos Petrovas Samuel Rotman Nathalie Piazzon Dina Milowich Nathalie Sala Chun-Yi Tsai Eleonore Multone Pierre-Yves Bochud Mauro Oddo Bettina Bisig Laurence de Leval Postmortem Cardiopulmonary Pathology in Patients with COVID-19 Infection: Single-Center Report of 12 Autopsies from Lausanne, Switzerland Diagnostics SARS-CoV-2 COVID-19 diffuse alveolar damage immunohistochemistry RNAscope reverse transcriptase quantitative PCR |
| title | Postmortem Cardiopulmonary Pathology in Patients with COVID-19 Infection: Single-Center Report of 12 Autopsies from Lausanne, Switzerland |
| title_full | Postmortem Cardiopulmonary Pathology in Patients with COVID-19 Infection: Single-Center Report of 12 Autopsies from Lausanne, Switzerland |
| title_fullStr | Postmortem Cardiopulmonary Pathology in Patients with COVID-19 Infection: Single-Center Report of 12 Autopsies from Lausanne, Switzerland |
| title_full_unstemmed | Postmortem Cardiopulmonary Pathology in Patients with COVID-19 Infection: Single-Center Report of 12 Autopsies from Lausanne, Switzerland |
| title_short | Postmortem Cardiopulmonary Pathology in Patients with COVID-19 Infection: Single-Center Report of 12 Autopsies from Lausanne, Switzerland |
| title_sort | postmortem cardiopulmonary pathology in patients with covid 19 infection single center report of 12 autopsies from lausanne switzerland |
| topic | SARS-CoV-2 COVID-19 diffuse alveolar damage immunohistochemistry RNAscope reverse transcriptase quantitative PCR |
| url | https://www.mdpi.com/2075-4418/11/8/1357 |
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