1Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.
2Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil.
Am J Trop Med Hyg. 2020 Oct;103(4):1604-1607. doi: 10.4269/ajtmh.20-0787.
Although high mortality has been reported in many COVID-19 studies, very limited postmortem information from complete autopsies is available. We report the findings in the adrenal glands in 28 autopsies with confirmed SARS-CoV-2 infection. Microscopic lesions were identified in the adrenal glands in 12/28 patients (46%). Seven cases showed necrosis, generally ischemic; four showed cortical lipid degeneration; two showed hemorrhage; and one unspecific focal adrenalitis. Vascular thrombosis in one patient and focal inflammation in association with other findings in three patients were observed. No case presented adrenal insufficiency. In conclusion, adrenal lesions are frequent in patients with severe COVID-19. The lesions are mild but could contribute to the lethal outcome.
尽管许多 COVID-19 研究报告了高死亡率，但完整尸检的死后信息非常有限。我们报告了 28 例经证实的 SARS-CoV-2 感染患者的尸检中肾上腺的发现。在 12/28 例患者（46%）的肾上腺中发现了显微镜下病变。7 例表现为坏死，通常为缺血性；4 例表现为皮质脂质变性；2 例表现为出血；1 例表现为非特异性局灶性肾上腺炎。1 例患者观察到血管血栓形成，3 例患者观察到与其他发现相关的局灶性炎症。无肾上腺功能不全病例。总之，严重 COVID-19 患者的肾上腺病变很常见。病变轻微，但可能导致致命结果。
