Postmortem Findings in Italian Patients With COVID-19: A Descriptive Full Autopsy Study of Cases With and Without Comorbidities

Author:

Falasca Laura1,Nardacci Roberta1,Colombo Daniele1,Lalle Eleonora1,Di Caro Antonino1ORCID,Nicastri Emanuele1,Antinori Andrea1,Petrosillo Nicola1,Marchioni Luisa1,Biava Gianluigi1,D’Offizi Gianpiero1,Palmieri Fabrizio1,Goletti Delia1,Zumla Alimuddin23,Ippolito Giuseppe1,Piacentini Mauro14,Del Nonno Franca1

Affiliation:

1. National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy

2. Department of Infection, Division of Infection and Immunity, University College London, London, United Kingdom

3. National Institute for Health Research Biomedical Research Centre, University College London Hospitals National Health Service Foundation Trust, London, United Kingdom

4. Laboratory of Cellular and Developmental Biology, Department of Biology, University of Rome Tor Vergata, Rome, Italy

Abstract

AbstractBackgroundDescriptions of the pathological features of coronavirus disease-2019 (COVID-19) caused by the novel zoonotic pathogen severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emanate from tissue biopsies, case reports, and small postmortem studies restricted to the lung and specific organs. Whole-body autopsy studies of COVID-19 patients have been sparse.MethodsTo further define the pathology caused by SARS-CoV-2 across all body organs, we performed autopsies on 22 patients with COVID-19 (18 with comorbidities and 4 without comorbidities) who died at the National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS Hospital, Rome, Italy. Tissues from the lung, heart, liver, kidney, spleen, and bone marrow (but not the brain) were examined. Only lung tissues were subject to transmission electron microscopy.ResultsCOVID-19 caused multisystem pathology. Pulmonary and cardiovascular involvement were dominant pathological features. Extrapulmonary manifestations included hepatic, kidney, splenic, and bone marrow involvement, and microvascular injury and thrombosis were also detected. These findings were similar in patients with or without preexisting medical comorbidities.ConclusionsSARS-CoV-2 infection causes multisystem disease and significant pathology in most organs in patients with and without comorbidities.

Funder

Regione Lazio

European Union

National Institutes of Health Research

Mahathir Foundation Science

Italian Ministry of Health

Ricerca Corrente

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Immunology and Allergy

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