Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Pathol Res Pract. 2020 Oct;216(10):153228. doi: 10.1016/j.prp.2020.153228. Epub 2020 Sep 19.
Since the outbreak of the novel coronavirus disease-2019 (COVID-19) in December 2019, limited studies have investigated the histopathologic findings of patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).
This study was conducted on 31 deceased patients who were hospitalized for COVID-19 in a tertiary hospital in Tehran, Iran. A total of 52 postmortem tissue biopsy samples were obtained from the lungs and liver of decedents. Clinical characteristics, laboratory data, and microscopic features were evaluated. Reverse transcription polymerase chain reaction (RT-PCR) assay for SARS-CoV-2 was performed on specimens obtained from nasopharyngeal swabs and tissue biopsies.
The median age of deceased patients was 66 years (range, 30-87 years) and 25 decedents (81 %) were male. The average interval from symptom onset to death was 13 days (range, 6-34 days). On histopathologic examination of the lung specimens, diffuse alveolar damage and thrombotic microangiopathy were the most common findings (80 % and 60 %, respectively). Liver specimens mainly showed macrovesicular steatosis, portal lymphoplasmacytic inflammation and passive congestion. No definitive viral inclusions were observed in any of the specimens. In addition, 92 % of lung tissue samples tested positive for SARS-CoV-2 by RT-PCR.
Further studies are needed to investigate whether SARS-CoV-2 causes direct cytopathic changes in various organs of the human body.
自 2019 年 12 月新型冠状病毒病-2019（COVID-19）爆发以来，有限的研究调查了严重急性呼吸综合征冠状病毒-2（SARS-CoV-2）感染患者的组织病理学发现。
本研究在伊朗德黑兰的一家三级医院对 31 名因 COVID-19 住院的已故患者进行，共从死者的肺部和肝脏获得 52 份尸检组织活检样本。评估了临床特征、实验室数据和显微镜特征。对从鼻咽拭子和组织活检获得的标本进行 SARS-CoV-2 的逆转录聚合酶链反应（RT-PCR）检测。
已故患者的中位年龄为 66 岁（范围 30-87 岁），25 名患者（81%）为男性。从症状发作到死亡的平均间隔为 13 天（范围 6-34 天）。在肺标本的组织病理学检查中，弥漫性肺泡损伤和血栓性微血管病是最常见的发现（分别为 80%和 60%）。肝标本主要表现为大泡性脂肪变性、门脉淋巴浆细胞炎症和被动充血。在任何标本中均未观察到明确的病毒包涵体。此外，92%的肺组织样本通过 RT-PCR 检测 SARS-CoV-2 呈阳性。
需要进一步研究以调查 SARS-CoV-2 是否会导致人体各种器官的直接细胞病变。
