Deacu Mariana, Enciu Manuela, Nicolau Antonela-Anca, Bălţătescu Gabriela Izabela, Neculai-Cândea Lavinia Simona, Deacu Sorin, Popa Marius Florentin
Clinical Pathology Service, St. Apostle Andrew Emergency County Hospital, Constanţa, Romania.
Faculty of Medicine, Ovidius University of Constanţa, Constanţa, Romania.
Histol Histopathol. 2023 May;38(5):513-524. doi: 10.14670/HH-18-561. Epub 2022 Nov 23.
COVID-19 is a systemic disease with multiorgan damage, which requires a better understanding and deepening of histopathogenesis in order to improve treatment. Autopsy remains a gold standard to establish certain diagnoses and to integrate the morphological spectrum of lung lesions, explaining the cause of death, into a clinical context.
The study included 57 autopsies performed during 2020-2021 associated with SARS-CoV-2 infection. Among the autopsies we performed, diffuse alveolar damage (DAD) was the most common pulmonary morphological change, 31.8% of them with acute or exudative phase and 33.3% with proliferative phase of DAD. Acute fibrous organizing pneumonia or organizing pneumonia with fibrous remodeling processes and pulmonary fibrosis were rarely observed. The most unfavorable outcome and death associated with SARS-CoV-2 infection was frequent in older men, with a high rate of comorbidities. Microscopically, SARS-CoV-2 presents many common aspects with MERS-CoV and SARS-CoV-1, such as alveolar hyaline membrane, desquamated alveolar cells, alveolar edema and alveolar and interstitial lymphocyte and monocytes infiltration.
Our study includes a large number of autopsies on patients with SARS-CoV-2 infection performed in Romania. COVID 19 associated pneumonia combines classical aspects of alveolar and interstitial pneumonia with some peculiarities. Autopsies are of major importance in understanding SARS-CoV-2 infection.
新型冠状病毒肺炎（COVID-19）是一种具有多器官损害的全身性疾病，为改善治疗效果，需要更好地理解并深入研究其组织病理学发病机制。尸检仍然是确立某些诊断以及将肺部病变的形态学谱（解释死亡原因）融入临床背景的金标准。
本研究纳入了2020年至2021年期间进行的57例与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染相关的尸检。在我们所进行的尸检中，弥漫性肺泡损伤（DAD）是最常见的肺部形态学改变，其中31.8%处于急性或渗出期，33.3%处于DAD的增殖期。急性纤维组织增生性肺炎或伴有纤维重塑过程的组织性肺炎以及肺纤维化很少被观察到。与SARS-CoV-2感染相关的最不利结局和死亡在老年男性中较为常见，且合并症发生率高。在显微镜下，SARS-CoV-2呈现出与中东呼吸综合征冠状病毒（MERS-CoV）和严重急性呼吸综合征冠状病毒1（SARS-CoV-1）许多共同的特征，如肺泡透明膜、肺泡上皮细胞脱落、肺泡水肿以及肺泡和间质淋巴细胞及单核细胞浸润。
我们的研究纳入了罗马尼亚大量SARS-CoV-2感染患者的尸检。新型冠状病毒肺炎相关肺炎兼具肺泡性和间质性肺炎的经典特征以及一些独特之处。尸检对于理解SARS-CoV-2感染至关重要。
