Institute of Pathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
Institute of Pathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
Int J Infect Dis. 2021 Jul;108:274-281. doi: 10.1016/j.ijid.2021.05.069. Epub 2021 Jun 3.
Studies on coronavirus disease 2019 (COVID-19) usually focus on middle-aged and older adults. However, younger patients may present with severe COVID-19 with potentially fatal outcomes. For optimized, more specialized therapeutic regimens in this particular patient group, a better understanding of the underlying pathomechanisms is of utmost importance.
Our study investigated relevant, pre-existing medical conditions, clinical histories, and autopsy findings, together with SARS-CoV-2-RNA, determined by qPCR, and laboratory data in six COVID-19 decedents aged 50 years or younger, who were autopsied at the Charité University Hospital.
From a total of 76 COVID-19 patients who underwent an autopsy at our institution, six (7.9%) were 50 years old or younger. Most of these younger COVID-19 decedents presented with pre-existing medical conditions prior to SARS-CoV-2 infection. These included overweight and obesity, arterial hypertension, asthma, and obstructive sleep apnea, as well as graft-versus-host disease following cancer and bone marrow transplantation. Furthermore, clinical histories and autopsy results revealed a disproportionally high prevalence of thromboembolism and ischemic organ damage in this patient cohort. Histopathology and laboratory results indicated coagulopathies, signs of immune dysregulation, and liver damage.
In conclusion, pre-existing health conditions may increase the risk of severe and fatal COVID-19 in younger patients, who may be especially prone to developing thromboembolic complications, immune dysregulation, and liver damage.
关于 2019 年冠状病毒病（COVID-19）的研究通常集中在中年及以上人群。然而，年轻患者可能会出现严重的 COVID-19，导致潜在的致命后果。为了在这一特定患者群体中优化更具针对性的治疗方案，深入了解潜在的发病机制至关重要。
我们的研究调查了 6 名年龄在 50 岁或以下的 COVID-19 死者的相关既往病史、临床病史和尸检结果，以及通过 qPCR 确定的 SARS-CoV-2-RNA 和实验室数据。这些患者均在 Charité 大学医院进行了尸检。
在我们机构接受尸检的 76 名 COVID-19 患者中，有 6 名（7.9%）年龄在 50 岁或以下。这些年轻 COVID-19 死者中，大多数在感染 SARS-CoV-2 之前就有既往疾病。这些疾病包括超重和肥胖、动脉高血压、哮喘和阻塞性睡眠呼吸暂停，以及癌症和骨髓移植后的移植物抗宿主病。此外，临床病史和尸检结果显示，该患者群体中血栓栓塞和缺血性器官损伤的比例过高。组织病理学和实验室结果表明存在凝血功能障碍、免疫失调和肝损伤的迹象。
总之，既往健康状况可能会增加年轻患者发生严重和致命 COVID-19 的风险，他们可能更容易发生血栓栓塞并发症、免疫失调和肝损伤。
