Rafael Parra-Medina1,2, Sabrina Herrera3, Jaime Mejia4. 1. Research Institute, Pathology Department, Fundación Univeristaria de Ciencias de la Salud, Bogotá, Colombia. 2. Instituto Nacional de Cancerología, Pathology Department, Bogotá, Colombia. 3. Department of Pathology Las Américas, Medellin, Colombia. 4. Instituto de Patologia Mejia Jimenez, Department of Pathology, Cali, Colombia.
Abstract
BACKGROUND: Histopathological analysis can provide additional clues in COVID-19 understanding. During the last year, autopsy reports have revealed that diffuse alveolar damage (DAD) is the most significant observed finding. The aim of this study is to review cases in the literature about COVID-19 autopsies that reported microthrombi in different organs. METHODS: We performed a systematic literature review in PubMed, Virtual Health Library (VHL), and Google Scholar. RESULTS: In total, 151 autopsies were included, and 91 cases presented microthrombi in the lung (73%), heart (11.2%), kidney (24%), and liver (16.3%). The age range was between 27 and 96 years. Males were 64.8%. The patients with microthrombi had more comorbidities such as arterial hypertension (62%), obesity or overweight (64%), diabetes mellitus type 2 (51%), and heart disease (53%). The most common histopathological changes found in patients with lung microthrombosis were DAD in exudative phase (78%), pulmonary embolism (59%), and lung infarct (81%). Presence of microthrombi was associated with arterial hypertension (p < 0.0001) and DAD in exudative and proliferative phases (p = 0.02). DISCUSSION: The analysis of these results shows that microthrombi in COVID-19 autopsies may be found in different organs and are more frequent in patients with comorbidities, pulmonary embolism, and lung infarct.
BACKGROUND: Histopathological analysis can provide additional clues in COVID-19 understanding. During the last year, autopsy reports have revealed that diffuse alveolar damage (DAD) is the most significant observed finding. The aim of this study is to review cases in the literature about COVID-19 autopsies that reported microthrombi in different organs. METHODS: We performed a systematic literature review in PubMed, Virtual Health Library (VHL), and Google Scholar. RESULTS: In total, 151 autopsies were included, and 91 cases presented microthrombi in the lung (73%), heart (11.2%), kidney (24%), and liver (16.3%). The age range was between 27 and 96 years. Males were 64.8%. The patients with microthrombi had more comorbidities such as arterial hypertension (62%), obesity or overweight (64%), diabetes mellitus type 2 (51%), and heart disease (53%). The most common histopathological changes found in patients with lung microthrombosis were DAD in exudative phase (78%), pulmonary embolism (59%), and lung infarct (81%). Presence of microthrombi was associated with arterial hypertension (p < 0.0001) and DAD in exudative and proliferative phases (p = 0.02). DISCUSSION: The analysis of these results shows that microthrombi in COVID-19 autopsies may be found in different organs and are more frequent in patients with comorbidities, pulmonary embolism, and lung infarct.
Authors: Thomas R Martin; Rachel L Zemans; Lorraine B Ware; Eric P Schmidt; David W H Riches; Lisa Bastarache; Carolyn S Calfee; Tushar J Desai; Susanne Herold; Catherine L Hough; Mark R Looney; Michael A Matthay; Nuala Meyer; Samir M Parikh; Troy Stevens; B Taylor Thompson Journal: Am J Respir Cell Mol Biol Date: 2022-09 Impact factor: 7.748
Authors: Kiruphagaran Thangaraju; Upendra Katneni; Imo J Akpan; Kenichi Tanaka; Tiffany Thomas; Saini Setua; Julie A Reisz; Francesca Cendali; Fabia Gamboni; Travis Nemkov; Stacie Kahn; Alexander Z Wei; Jacob E Valk; Krystalyn E Hudson; David J Roh; Chiara Moriconi; James C Zimring; Angelo D'Alessandro; Steven L Spitalnik; Richard O Francis; Paul W Buehler Journal: Front Med (Lausanne) Date: 2022-01-10