Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study.
Ann Intern Med
; 173(4): 268-277, 2020 08 18.
Статья
в английский
| MEDLINE | ID: covidwho-2110835
ABSTRACT
BACKGROUND:
The new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused more than 210 000 deaths worldwide. However, little is known about the causes of death and the virus's pathologic features.OBJECTIVE:
To validate and compare clinical findings with data from medical autopsy, virtual autopsy, and virologic tests.DESIGN:
Prospective cohort study.SETTING:
Autopsies performed at a single academic medical center, as mandated by the German federal state of Hamburg for patients dying with a polymerase chain reaction-confirmed diagnosis of COVID-19. PATIENTS The first 12 consecutive COVID-19-positive deaths. MEASUREMENTS Complete autopsy, including postmortem computed tomography and histopathologic and virologic analysis, was performed. Clinical data and medical course were evaluated.RESULTS:
Median patient age was 73 years (range, 52 to 87 years), 75% of patients were male, and death occurred in the hospital (n = 10) or outpatient sector (n = 2). Coronary heart disease and asthma or chronic obstructive pulmonary disease were the most common comorbid conditions (50% and 25%, respectively). Autopsy revealed deep venous thrombosis in 7 of 12 patients (58%) in whom venous thromboembolism was not suspected before death; pulmonary embolism was the direct cause of death in 4 patients. Postmortem computed tomography revealed reticular infiltration of the lungs with severe bilateral, dense consolidation, whereas histomorphologically diffuse alveolar damage was seen in 8 patients. In all patients, SARS-CoV-2 RNA was detected in the lung at high concentrations; viremia in 6 of 10 and 5 of 12 patients demonstrated high viral RNA titers in the liver, kidney, or heart.LIMITATION:
Limited sample size.CONCLUSION:
The high incidence of thromboembolic events suggests an important role of COVID-19-induced coagulopathy. Further studies are needed to investigate the molecular mechanism and overall clinical incidence of COVID-19-related death, as well as possible therapeutic interventions to reduce it. PRIMARY FUNDING SOURCE University Medical Center Hamburg-Eppendorf.
Полный текст:
Имеется в наличии
Коллекция:
Международные базы данных
база данных:
MEDLINE
Основная тема:
Pneumonia, Viral
/
Pulmonary Embolism
/
Autopsy
/
Coronavirus Infections
/
Venous Thromboembolism
Тип исследования:
Когортное исследование
/
Экспериментальные исследования
/
Наблюдательное исследование
/
Прогностическое исследование
Пределы темы:
Пожилые
/
Женщины
/
Люди
/
Мужчины
/
Middle aged
Страна как тема:
Европа
Язык:
английский
Журнал:
Ann Intern Med
Год:
2020
Тип:
Статья
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