Pathomorphological changes in some organs and tissues of COVID-19 convalescent patients

New coronavirus infection (COVID-19) is highly contagious viral disease caused by SARS-CoV-2 leading to the pandemic. The autopsy of COVID-19 patients often showed features of previous brain diseases including neurodegeneration, previous strokes, demyelinating diseases and atherosclerosis. Patients with acute cerebrovascular accidents and severe COVID-19 had higher numbers of lethality in comparison to non-severe course of infection without cerebrovascular accidents. A comparative analysis of morphological changes in lungs of deceased patients who died in different periods of first clinical symptoms is to be conducted. Objective. Description of pathomorphological changes in deceased patients during the period of reconvalescence. Patients and methods. The analysis of 15 fatal cases which took place in Botkin Hospital with the diagnosis of ischemic stroke and new coronavirus infection in the previous 2-4 months has been held. Macro and microscope examination of brain, lungs, brachiocephalic arteries, kidneys and liver has been carried out. Results. All patients had morphological features of ischemic damage of grey matter in the brain. Beside necrosis of neurocytes with diffuse infiltration in the grey matter, hematoxylin cycles were found, in some cases they were placed in a perivascular way in choroid plexus. Also 5 patients suffered a myocardial infarction up to 3 days. 10 patients had structures disorganisation in areas of lung parenchyma with hystoacrchitectonic changes because of the fibrosis. Alveoli in some places collaborated mostly with single airway clearance. The fact that most patients had lung hemosiderosis can prove coronavirus infection suffered earlier with microcirculatory bed damage. Conclusion. Thus, morphological changes seen in the period of reconvalescence of COVID-19 is a result of pathomorphosis of changes described earlier for acute period of coronavirus infection and affect not only lungs, but also other organs and tissues. This proves systematic characteristic of the infection.

COVID-19 as many-faced Janus. On the classification of a new coronavirus infection

The spectrum of the clinical manifestations in patients with COVID-19 varies from asymptomatic to severe forms of the disease leading to death. The most commonly affected in patients with COVID-19 system is the respiratory system, but other organ systems can also be affected by the virus. We propose a classification of the clinical forms of COVID-19, which includes: acute respiratory infection (affecting only the upper respiratory tract);pneumonia: without ARF, with ARF;anosmia/parosmia/ cacosmia;cerebral form (meningitis, meningoencephalitis);gastrointestinal form, including hepatitis;oligosymptomatic form/ asymptomatic form;combined forms. Sepsis, septic (infectious-toxic) shock;DIC, thrombosis and thromboembolism are proposed to be considered as complications of the underlying disease. Present classification can help clinicians to diagnose COVID-19 at an early stage, identify atypical infection forms, and assign appropriate treatment. © 2021, Dynasty Publishing House. All rights reserved.