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SARS-CoV-2 逆转录聚合酶链反应阳性病例肺外器官死后病理学变化:单中心经验。

Postmortem pathological changes in extrapulmonary organs in SARS-CoV-2 rt-PCR-positive cases: a single-center experience.

机构信息

Morgue Department, Histopathology Unit, Council of Forensic Medicine, Istanbul, Turkey.

Morgue Department, Autopsy Unit, Council of Forensic Medicine, Istanbul, Turkey.

出版信息

Ir J Med Sci. 2022 Feb;191(1):81-91. doi: 10.1007/s11845-021-02638-8. Epub 2021 May 7.

Abstract

BACKGROUND

Although the lung is seen as the main target organ affected by SARS-CoV-2, other organs are also damaged.

AIM

We aimed to determine the extrapulmonary findings of autopsies performed on cases with positive results with postmortem polymerase chain reaction test.

METHODS

Pathological changes in extrapulmonary organs were examined with light microscopy.

RESULTS

Heart, liver, spleen, kidney, pancreas, and central nervous system samples of these cases were evaluated. About 80% of the cases were men, and 20% were women. In the examination of heart, 28 of the cases had scar, 14 had acute myocardial infarction, 6 had acute and previous myocardial infarction findings, 2 had myocarditis, and 4 had interstitial mononuclear inflammatory cell infiltration. In the examination of the liver, portal inflammation was observed in 84 of the cases, steatosis in 54, centrilobular necrosis in 9, and capillary endotheliitis in the portal area in 7 of them. In the evaluation of the kidney, 37 cases had chronic pyelonephritis, 36 had tubular damage, 15 had tubulointerstitial necrosis, 16 had subcapsular microhemorrhage, 10 had capillary endothelitis, and 9 had a microvascular fibrin trombosis in their glomerular capillaries. In the central nervous system, 8 cases had infarction and liquefaction, 56 had perivascular petechial hemorrhage, 54 had acute hypoxic ischemic change, 3 had parenchymal microhemorrhage, and 52 had capillary endotheliitis.

CONCLUSION

Autopsies play an important role in systematically examining the damage caused by the virus in all organs in order to elucidate the pathogenesis of SARS-CoV-2 infection and contribute to the clinical management of infected patients.

摘要

背景

虽然肺被认为是受 SARS-CoV-2 影响的主要靶器官,但其他器官也受到了损害。

目的

我们旨在确定通过死后聚合酶链反应试验检测呈阳性结果的病例的肺外发现。

方法

用光学显微镜检查肺外器官的病理变化。

结果

评估了这些病例的心脏、肝脏、脾脏、肾脏、胰腺和中枢神经系统样本。大约 80%的病例为男性,20%为女性。在心脏检查中,28 例有瘢痕,14 例有急性心肌梗死,6 例有急性和陈旧性心肌梗死表现,2 例有心肌炎,4 例有间质单核炎性细胞浸润。在肝脏检查中,84 例有门脉炎症,54 例有脂肪变性,9 例有中隔坏死,7 例有门脉区毛细血管内皮炎。在肾脏评估中,37 例有慢性肾盂肾炎,36 例有肾小管损伤,15 例有肾小管间质性坏死,16 例有包膜下微出血,10 例有毛细血管内皮炎,9 例有肾小球毛细血管微血栓形成。在中枢神经系统中,8 例有梗死和液化,56 例有血管周围瘀点出血,54 例有急性缺氧缺血性改变,3 例有实质微出血,52 例有毛细血管内皮炎。

结论

尸检在系统检查病毒对所有器官造成的损害方面发挥着重要作用,以便阐明 SARS-CoV-2 感染的发病机制,并有助于感染患者的临床管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4a7/8104039/1a0f2f7a4562/11845_2021_2638_Fig1_HTML.jpg

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