Abdaljaleel Maram, Tawalbeh Isra, Sallam Malik, Hani Amjad Bani, Al-Abdallat Imad M, Omari Baheth Al, Al-Mustafa Sahar, Abder-Rahman Hasan, Abbas Adnan Said, Zureigat Mahmoud, Al-Abbadi Mousa A
Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan.
Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan.
J Pathol Transl Med. 2023 Mar;57(2):102-112. doi: 10.4132/jptm.2023.01.30. Epub 2023 Mar 14.
Coronavirus disease 2019 (COVID-19) has emerged as a pandemic for more than 2 years. Autopsy examination is an invaluable tool to understand the pathogenesis of emerging infections and their consequent mortalities. The aim of the current study was to present the lung and heart pathological findings of COVID-19-positive autopsies performed in Jordan.
The study involved medicolegal cases, where the cause of death was unclear and autopsy examination was mandated by law. We included the clinical and pathologic findings of routine gross and microscopic examination of cases that were positive for COVID-19 at time of death. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed through molecular detection by real-time polymerase chain reaction, serologic testing for IgM and electron microscope examination of lung samples.
Seventeen autopsies were included, with male predominance (76.5%), Jordanians (70.6%), and 50 years as the mean age at time of death. Nine out of 16 cases (56.3%) had co-morbidities, with one case lacking such data. Histologic examination of lung tissue revealed diffuse alveolar damage in 13/17 cases (76.5%), and pulmonary microthrombi in 8/17 cases (47.1%). Microscopic cardiac findings were scarcely detected. Two patients died as a direct result of acute cardiac disease with limited pulmonary findings.
The detection of SARS-CoV-2 in postmortem examination can be an incidental or contributory finding which highlights the value of autopsy examination to determine the exact cause of death in controversial cases.
2019年冠状病毒病（COVID-19）已成为大流行病超过2年。尸检是了解新发感染的发病机制及其所致死亡情况的宝贵工具。本研究的目的是展示在约旦进行的COVID-19阳性尸检的肺和心脏病理结果。
该研究涉及法医学案例，即死因不明且依法必须进行尸检的情况。我们纳入了死亡时COVID-19呈阳性病例的常规大体和显微镜检查的临床及病理结果。通过实时聚合酶链反应进行分子检测、IgM血清学检测以及对肺样本进行电子显微镜检查来确认严重急性呼吸综合征冠状病毒2（SARS-CoV-2）检测结果。
共纳入17例尸检，男性占主导（76.5%），约旦人占（70.6%），平均死亡年龄为50岁。16例中有9例（56.3%）有合并症，1例缺乏此类数据。肺组织的组织学检查显示，13/17例（76.5%）有弥漫性肺泡损伤，8/17例（47.1%）有肺微血栓形成。显微镜下心脏检查结果几乎未被发现。2例患者直接死于急性心脏病，肺部表现有限。
在尸检中检测到SARS-CoV-2可能是一个偶然或促成死亡的发现，这凸显了尸检在确定有争议病例的确切死因方面的价值。
