Purohit Abhishek, Vaswani Shruti, Vishwajeet Vikarn, Kumar Deepak, Vijayvergiya Parag, Tripathi Swapnil, Kanchan Tanuj, Kothari Nikhil, Dutt Naveen, Elhence Poonam, Nag Vijayalakshmi, Bhatia Pradeep, Garg Mahendra K, Misra Sanjeev
Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan India.
Department of Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan India.
Indian J Hematol Blood Transfus. 2022 Apr;38(2):416-421. doi: 10.1007/s12288-021-01489-8. Epub 2021 Sep 20.
The 2019 novel coronavirus (2019-nCoV) originated in Wuhan City of China. In India, first confirmed case of coronavirus disease (COVID-19) was reported on January 30, 2020 and India is presently hit by second wave of COVID-19. The aim of the present study was to evaluate bone marrow findings of COVID-19 by minimally invasive autopsies to aid in understanding pathophysiology of the disease. This prospective study was conducted at tertiary care centre of Western Rajasthan. After obtaining approval from Institute's ethics committee and consent from next of kins, minimally invasive autopsies were conducted in 37 COVID-19 deceased patients within an hour after the death. The tissue specimens were processed with standard biosafety measures. Electronic medical records were reviewed retrospectively and patients' clinical details and results of laboratory investigations were noted. In this prospective study, bone marrow biopsies were collected from 37 COVID-19 minimally invasive autopsies. Mean age of these cases was 61.8 years and male: female ratio was 2.36. Comorbidities were observed in 25 (67.5%) of all cases. Histopathological analysis revealed hypercellular, normocellular and hypocellular marrow in 5, 25 and 5 cases respectively (two biopsies were inadequate). There was marked interstitial prominence of histiocytes in 24 (68.5%) cases. Out of these, evidence of haemophagocytosis was observed in 14 (40%) cases, marked increase of haemosiderin laden macrophages in 20 (57.1%) cases. There was prominence of plasma cells in 28 (80%) cases. The present study attempted to fill the gap of dearth of literature from our country in COVID-19 autopsy studies by highlighting bone marrow findings. The data support the evidence of development of secondary haemophagocytic lymphocytosis in COVID-19 cases.
2019新型冠状病毒（2019 - nCoV）起源于中国武汉市。在印度，2020年1月30日报告了首例冠状病毒病（COVID - 19）确诊病例，印度目前正遭受第二波COVID - 19疫情的冲击。本研究的目的是通过微创尸检评估COVID - 19的骨髓表现，以帮助理解该疾病的病理生理学。这项前瞻性研究在拉贾斯坦邦西部的三级医疗中心进行。在获得研究所伦理委员会的批准和近亲的同意后，对37例COVID - 19死亡患者在死亡后一小时内进行了微创尸检。组织标本采用标准生物安全措施进行处理。回顾性查阅电子病历，记录患者的临床细节和实验室检查结果。在这项前瞻性研究中，从37例COVID - 19微创尸检中采集了骨髓活检样本。这些病例的平均年龄为61.8岁，男女比例为2.36。所有病例中有25例（67.5%）存在合并症。组织病理学分析显示，分别有5例、25例和5例骨髓细胞增多、细胞数量正常和细胞减少（两份活检样本不充分）。24例（68.5%）病例中可见组织细胞明显的间质突出。其中，14例（40%）病例有噬血细胞现象的证据，20例（57.1%）病例中含铁血黄素巨噬细胞明显增多。28例（80%）病例中有浆细胞突出。本研究试图通过突出骨髓表现来填补我国在COVID - 19尸检研究方面文献匮乏的空白。数据支持COVID - 19病例中继发性噬血细胞性淋巴细胞增多症发展的证据。
