OBJECTIVES: Covid-19 pandemic started in December 2019. Histopathological studies are critical in better understanding of the disease. Minimally invasive biopsy techniques provide a suitable Methods: This was a single-centre observational study conducted at JPNTC AIIMS. 37 patients who died of Covid-19 were enrolled. Post-mortem percutaneous biopsies were taken from lung, heart, liver, kidney and stained with haematoxylin and eosin. Immunohistochemistry was performed using CD61 and CD163. SARS-CoV-2 virus was detected using IHC with primary antibodies. RESULTS: The mean age was 48.7years and 59.5% of them were males. Lung histopathology showed diffuse alveolar damage in 78% patients. Associated bronchopneumonia was seen in 37.5% and scattered microthrombi in 21% patients. Immunopositivity for SARS-CoV-2 was observed in Type II pneumocytes. Acute tubular injury with epithelial vacuolization was seen in 46% of renal biopsies. 71% of liver biopsies showed Kupfer cell hyperplasia and 27.5% showed submassive hepatic necrosis. CONCLUSIONS: Predominant finding was diffuse alveolar damage with demonstration of SARS-CoV-2 protein in the acute phase. Microvascular thrombi were rarely identified in any organ. Substantial hepatocyte necrosis, Kupffer cell hypertrophy, micro, and macrovesicular steatosis unrelated to microvascular thrombi suggests that liver might be a primary target of Covid-19.
OBJECTIVES:Covid-19 pandemic started in December 2019. Histopathological studies are critical in better understanding of the disease. Minimally invasive biopsy techniques provide a suitable Methods: This was a single-centre observational study conducted at JPNTC AIIMS. 37 patients who died of Covid-19 were enrolled. Post-mortem percutaneous biopsies were taken from lung, heart, liver, kidney and stained with haematoxylin and eosin. Immunohistochemistry was performed using CD61 and CD163. SARS-CoV-2 virus was detected using IHC with primary antibodies. RESULTS: The mean age was 48.7years and 59.5% of them were males. Lung histopathology showed diffuse alveolar damage in 78% patients. Associated bronchopneumonia was seen in 37.5% and scattered microthrombi in 21% patients. Immunopositivity for SARS-CoV-2 was observed in Type II pneumocytes. Acute tubular injury with epithelial vacuolization was seen in 46% of renal biopsies. 71% of liver biopsies showed Kupfer cell hyperplasia and 27.5% showed submassive hepatic necrosis. CONCLUSIONS: Predominant finding was diffuse alveolar damage with demonstration of SARS-CoV-2 protein in the acute phase. Microvascular thrombi were rarely identified in any organ. Substantial hepatocyte necrosis, Kupffer cell hypertrophy, micro, and macrovesicular steatosis unrelated to microvascular thrombi suggests that liver might be a primary target of Covid-19.
Authors: James Robert Pellegrini; Bhanu Sabbula; Jose R Russe-Russe; Rezwan F Munshi; Daniel Meshoyrer; Nourma Sajid; Alex Gutierrez; Swapna Munnangi; Elisa Szydziak; Jagadish Akella Journal: BMJ Open Gastroenterol Date: 2021-11