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11例因新型冠状病毒肺炎死亡患者肺部尸检的组织病理学检查:病例系列

Histopathological Examination of Lung Necropsy of 11 Patients Who Died Due to COVID-19: A Case Series.

作者信息

Nikkhoo Bahram, Naseri Karim, Rahimi Darehbagh Ramyar, Habiby Mehrdad, Moasses-Ghafari Bahar

机构信息

Department of Pathology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

Department of Anesthesiology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

出版信息

Iran J Pathol. 2024 Winter;19(1):126-131. doi: 10.30699/IJP.2023.2008773.3153. Epub 2023 Dec 29.

Abstract

COVID-19 is known to present with acute respiratory distress syndrome pathological manifestations. Studies have shown that patients with COVID-19 can develop diffuse alveolar damage, acute bronchopneumonia, necrotic bronchiolitis, and viral pneumonia. In this study, we investigated 11 cases. Needle necropsies of 11 patients, hospitalized at Tohid and Kowsar hospitals of Kurdistan University of Medical Sciences, with a positive antemortem SARS-CoV-2 (COVID-19) real-time PCR test, were fixated within 3 hours after death in the negative-pressure isolation morgue. The participants included six men (54%) and five women (46%) with a mean age of 73.82±10.58 (52-86) years old. The average hospitalization was 14.27±15.72 days. The results showed interstitial lymphocytic pneumonitis in most of the cases, varied from mild to moderate and up to severe in some cases. In 7 cases, anthracosis was noted, while one case demonstrated anthracosis with fibrosis. The hyaline membrane was reported in two patients. In one case, severe interstitial lymphocytic pneumonia with intra-alveolar exudate with organization, lithiasis, bronchiolitis pattern (BOOP), intra-alveolar hemorrhage, and mild fibrosis were seen. As a result, it is suggested to keep an eye on these pathologies in management of the severe cases of COVID-19 infection.

摘要

已知新冠病毒病会出现急性呼吸窘迫综合征的病理表现。研究表明,新冠病毒病患者可出现弥漫性肺泡损伤、急性支气管肺炎、坏死性细支气管炎和病毒性肺炎。在本研究中,我们调查了11例病例。对库尔德斯坦医科大学托希德医院和科萨尔医院收治的11例生前严重急性呼吸综合征冠状病毒2(新冠病毒病)实时聚合酶链反应检测呈阳性的患者进行了针吸尸检,在负压隔离停尸房于死亡后3小时内进行固定。参与者包括6名男性(54%)和5名女性(46%),平均年龄为73.82±10.58(52 - 86)岁。平均住院时间为14.27±15.72天。结果显示,大多数病例为间质性淋巴细胞性肺炎,程度从轻度到中度不等,部分病例可达重度。7例发现炭末沉着症,1例显示炭末沉着症伴纤维化。2例患者出现透明膜。1例患者可见严重的间质性淋巴细胞性肺炎伴肺泡内渗出物机化、结石形成、细支气管炎样改变(闭塞性细支气管炎伴机化性肺炎)、肺泡内出血和轻度纤维化。因此,建议在新冠病毒病感染重症病例的管理中关注这些病理情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3157/11164306/83b64d7667f2/ijp-19-126-g001.jpg

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