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新型冠状病毒肺炎患者肺、心脏和肝脏经皮组织芯活检的组织病理学和病毒学特征:一项临床病理病例系列研究

Histopathological and virological features of lung, heart and liver percutaneous tissue core biopsy in patients with COVID-19: A clinicopathological case series.

作者信息

Ramos-Rincon J M, Alenda C, García-Sevila R, Silva-Ortega S, García-Navarro M, Vidal I, Ribes I, Portilla J, Cintas A, Moreno-Pérez O, Sánchez-Martínez R, Merino E, Aranda I

机构信息

Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Internal Medicine Department, PintorBaeza, 12, 03010, Alicante, Spain.

Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Pathology Department, PintorBaeza, 12, 03010, Alicante, Spain.

出版信息

Malays J Pathol. 2022 Apr;44(1):83-92.

Abstract

INTRODUCTION

Data on pathological changes in COVID-19 are scarce. The aim of this study was to describe the histopathological and virological findings of postmortem biopsies, and the existing clinical correlations, in people who died of COVID-19.

MATERIALS AND METHODS

We performed postmortem needle core biopsies of the chest in 11 people who died of COVID-19 pneumonia. Tissue examination was done by light microscopy and real-time polymerase chain reaction (RTPCR).

RESULTS

The age of the patients were between 61 to 94 years. Of the 11 postmortem chest biopsies, lung tissue was obtained in 8, myocardium tissue in 7, and liver tissue in 5. Histologically of lung, the main findings pertaining to the lung were diffuse alveolar damage in proliferative phase (n = 4, 50%), diffuse alveolar damage in exudative and proliferative phase (n = 3, 37.5%), diffuse alveolar damage in exudative (n=1; 12.5%) and acute pneumonia (n = 2, 25%). Necrotising pneumonia, acute fibrinous and organising pneumonia, and neutrophils were detected in one sample each (12.5%). Another case presented myocarditis. RT-PCR showed RNA of SARS-CoV-2 in 7 of the 8 lung samples (87.5%), 2 of the 7 myocardial tissue samples (28.6%), and 1 of the 5 liver tissue samples (20%).

CONCLUSION

The postmortem examinations show diffuse alveolar damage, as well as acute or necrotising pneumonia. RT-PCR of SARS-CoV-2 was positive in most lung samples.

摘要

引言

关于新型冠状病毒肺炎(COVID-19)病理变化的数据稀缺。本研究旨在描述死于COVID-19患者的尸检活检组织病理学和病毒学发现,以及现有的临床相关性。

材料与方法

我们对11例死于COVID-19肺炎的患者进行了胸部尸检针吸活检。通过光学显微镜和实时聚合酶链反应(RT-PCR)进行组织检查。

结果

患者年龄在61至94岁之间。在11例尸检胸部活检中,8例获得肺组织,7例获得心肌组织,5例获得肝组织。在肺组织学方面,主要的肺部发现为增殖期弥漫性肺泡损伤(n = 4,50%)、渗出和增殖期弥漫性肺泡损伤(n = 3,37.5%)、渗出期弥漫性肺泡损伤(n = 1;12.5%)和急性肺炎(n = 2,25%)。在一个样本中分别检测到坏死性肺炎、急性纤维素性和机化性肺炎以及中性粒细胞(各占12.5%)。另一例表现为心肌炎。RT-PCR显示,8份肺样本中有7份(87.5%)、7份心肌组织样本中有2份(28.6%)、5份肝组织样本中有1份(20%)检测到严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的RNA。

结论

尸检显示弥漫性肺泡损伤以及急性或坏死性肺炎。大多数肺样本中SARS-CoV-2的RT-PCR呈阳性。

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