Author:
Ruiz-Cáceres Inmaculada,Hermida Romero Teresa,Guerra Merino Isabel,Portu Zapirain Joseba,Pérez-Mies Belén,Sánchez-Conde Matilde,Riaño Marina Alonso,Rubio Rafael,Fortés Alen Jose,Vidal González Ánxela,Salas Antón Clara,Múñez Elena,Sánchez Sánchez Rafael,Corona-Mata Diana,Aldecoa Ansorregui Iban,Miró José M.,Beloqui Pérez de Obanos Raquel,Ibero Carlos,Gómez-Román Javier,Fariñas M. Carmen,Tabuyo Bello Teresa,de Alava Enrique,Cisneros José Miguel,Matías-Guiu Xavier,Rivero Antonio,
Abstract
IntroductionWhole-body autopsies may be crucial to understand coronavirus disease 2019 (COVID-19) pathophysiology. We aimed to analyze pathological findings in a large series of full-body autopsies, with a special focus on superinfections.MethodsThis was a prospective multicenter study that included 70 COVID-19 autopsies performed between April 2020 and February 2021. Epidemiological, clinical and pathological information was collected using a standardized case report form.ResultsMedian (IQR) age was 70 (range 63.75–74.25) years and 76% of cases were males. Most patients (90%,) had at least one comorbidity prior to COVID-19 diagnosis, with vascular risk factors being the most frequent. Infectious complications were developed by 65.71% of the patients during their follow-up. Mechanical ventilation was required in most patients (75.71%) and was mainly invasive. In multivariate analyses, length of hospital stay and invasive mechanical ventilation were significantly associated with infections (p = 0.036 and p = 0.013, respectively). Necropsy findings revealed diffuse alveolar damage in the lungs, left ventricular hypertrophy in the heart, liver steatosis and pre-infection arteriosclerosis in the heart and kidneys.ConclusionOur study confirms the main necropsy histopathological findings attributed to COVID-19 in a large patient series, while underlining the importance of both comorbid conditions and superinfections in the pathology.