Younger age is associated with cardiovascular pathological phenotype of severe COVID-19 at autopsy
IntroductionCOVID-19 affects patients of all ages. There are few autopsy studies focusing on the younger population. We assessed an autopsy cohort aiming to understand how age influences pathological outcomes in fatal COVID-19.MethodsThis study included autopsied patients, aged 6 months to 83 years,...
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1327415/full |
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| author | Fernando R. Giugni Fernando R. Giugni Amaro N. Duarte-Neto Amaro N. Duarte-Neto Luiz Fernando F. da Silva Luiz Fernando F. da Silva Luiz Fernando F. da Silva Renata A. A. Monteiro Thais Mauad Thais Mauad Paulo H. N. Saldiva Paulo H. N. Saldiva Marisa Dolhnikoff Marisa Dolhnikoff |
| author_facet | Fernando R. Giugni Fernando R. Giugni Amaro N. Duarte-Neto Amaro N. Duarte-Neto Luiz Fernando F. da Silva Luiz Fernando F. da Silva Luiz Fernando F. da Silva Renata A. A. Monteiro Thais Mauad Thais Mauad Paulo H. N. Saldiva Paulo H. N. Saldiva Marisa Dolhnikoff Marisa Dolhnikoff |
| author_sort | Fernando R. Giugni |
| collection | DOAJ |
| description | IntroductionCOVID-19 affects patients of all ages. There are few autopsy studies focusing on the younger population. We assessed an autopsy cohort aiming to understand how age influences pathological outcomes in fatal COVID-19.MethodsThis study included autopsied patients, aged 6 months to 83 years, with confirmed COVID-19 in 2020–2021. We collected tissue samples from deceased patients using a minimally invasive autopsy protocol and assessed pathological data following a systematic approach.ResultsEighty-six patients were included, with a median age of 55 years (IQR 32.3–66.0). We showed that age was significantly lower in patients with acute heart ischemia (p = 0.004), myocarditis (p = 0.03) and lung angiomatosis (p < 0.001), and significantly higher in patients with exudative diffuse alveolar damage (p = 0.02), proliferative diffuse alveolar damage (p < 0.001), lung squamous metaplasia (p = 0.003) and lung viral atypia (p = 0.03), compared to patients without those findings. We stratified patients by their age and showed that cardiovascular findings were more prevalent in children and young adults. We performed principal component analysis and cluster of pathological variables, and showed that cardiovascular variables clustered and covariated together, and separated from pulmonary variables.ConclusionWe showed that age modulates pathological outcomes in fatal COVID-19. Younger age is associated with cardiovascular abnormalities and older age with pulmonary findings. |
| first_indexed | 2024-03-08T16:06:01Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-08T16:06:01Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-fb51d362259e4c50bfd12846f110bc7b2024-01-08T06:24:33ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-01-011010.3389/fmed.2023.13274151327415Younger age is associated with cardiovascular pathological phenotype of severe COVID-19 at autopsyFernando R. Giugni0Fernando R. Giugni1Amaro N. Duarte-Neto2Amaro N. Duarte-Neto3Luiz Fernando F. da Silva4Luiz Fernando F. da Silva5Luiz Fernando F. da Silva6Renata A. A. Monteiro7Thais Mauad8Thais Mauad9Paulo H. N. Saldiva10Paulo H. N. Saldiva11Marisa Dolhnikoff12Marisa Dolhnikoff13Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilDivision of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, United StatesDivision of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, United StatesLIM 05 - Laboratório de Patologia Ambiental e Experimental, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilDepartamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilLIM 05 - Laboratório de Patologia Ambiental e Experimental, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilSVOC - Serviço de Verificação de Óbitos da Capital, Universidade de São Paulo, São Paulo, BrazilDepartamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilDepartamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilLIM 05 - Laboratório de Patologia Ambiental e Experimental, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilDepartamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilLIM 05 - Laboratório de Patologia Ambiental e Experimental, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilDepartamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilLIM 05 - Laboratório de Patologia Ambiental e Experimental, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilIntroductionCOVID-19 affects patients of all ages. There are few autopsy studies focusing on the younger population. We assessed an autopsy cohort aiming to understand how age influences pathological outcomes in fatal COVID-19.MethodsThis study included autopsied patients, aged 6 months to 83 years, with confirmed COVID-19 in 2020–2021. We collected tissue samples from deceased patients using a minimally invasive autopsy protocol and assessed pathological data following a systematic approach.ResultsEighty-six patients were included, with a median age of 55 years (IQR 32.3–66.0). We showed that age was significantly lower in patients with acute heart ischemia (p = 0.004), myocarditis (p = 0.03) and lung angiomatosis (p < 0.001), and significantly higher in patients with exudative diffuse alveolar damage (p = 0.02), proliferative diffuse alveolar damage (p < 0.001), lung squamous metaplasia (p = 0.003) and lung viral atypia (p = 0.03), compared to patients without those findings. We stratified patients by their age and showed that cardiovascular findings were more prevalent in children and young adults. We performed principal component analysis and cluster of pathological variables, and showed that cardiovascular variables clustered and covariated together, and separated from pulmonary variables.ConclusionWe showed that age modulates pathological outcomes in fatal COVID-19. Younger age is associated with cardiovascular abnormalities and older age with pulmonary findings.https://www.frontiersin.org/articles/10.3389/fmed.2023.1327415/fullchildrenMIS-CmyocarditispathologySARS-CoV-2 |
| spellingShingle | Fernando R. Giugni Fernando R. Giugni Amaro N. Duarte-Neto Amaro N. Duarte-Neto Luiz Fernando F. da Silva Luiz Fernando F. da Silva Luiz Fernando F. da Silva Renata A. A. Monteiro Thais Mauad Thais Mauad Paulo H. N. Saldiva Paulo H. N. Saldiva Marisa Dolhnikoff Marisa Dolhnikoff Younger age is associated with cardiovascular pathological phenotype of severe COVID-19 at autopsy Frontiers in Medicine children MIS-C myocarditis pathology SARS-CoV-2 |
| title | Younger age is associated with cardiovascular pathological phenotype of severe COVID-19 at autopsy |
| title_full | Younger age is associated with cardiovascular pathological phenotype of severe COVID-19 at autopsy |
| title_fullStr | Younger age is associated with cardiovascular pathological phenotype of severe COVID-19 at autopsy |
| title_full_unstemmed | Younger age is associated with cardiovascular pathological phenotype of severe COVID-19 at autopsy |
| title_short | Younger age is associated with cardiovascular pathological phenotype of severe COVID-19 at autopsy |
| title_sort | younger age is associated with cardiovascular pathological phenotype of severe covid 19 at autopsy |
| topic | children MIS-C myocarditis pathology SARS-CoV-2 |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1327415/full |
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