Where does SARS-CoV-2 go to in man?†.

SARS-CoV-2 virus, the cause of COVID-19 disease, establishes infection in the human body via interaction with the angiotensin-converting enzyme 2 (ACE2) receptor on cell membranes. The lung is the major organ affected, and all respiratory epithelium from nose to alveolus is infectable. A recent study published in The Journal of Pathology looked at a wide range of other human tissues, mostly autopsy-derived, to identify susceptible cells. The virus (associated with ACE2) is found in all endothelial cells (an important finding), renal and biliary epithelium, in megakaryocytes, and occasionally in hepatocytes. It was not found in heart myofibres or brain neurones but is present in gut myenteric plexus cells. This work confirms previous work on SARS-CoV-2-infectable cells, and so supports investigations into the pathogenesis of COVID-19 disease as it affects (or does not directly affect) the different organs. © 2022 The Pathological Society of Great Britain and Ireland.

Pandemics and pathology: a reflection on influenza, HIV/AIDS and SARS (COVID-19) pandemic infections.

The COVID-19 pandemic has reminded pathologists of our significant roles in the management and understanding of rapidly spreading and dangerous pathogens, from identifying the agent to characterizing the clinical pathology to managing the dead. Cellular pathology - through autopsy - has depicted the main features: viral pneumonitis, acute lung injury, organising pneumonia, secondary bacterial pneumonia, thrombophilia and infarction, and systemic inflammatory response syndrome with multi-organ failure. These are similar to another viral pandemic of the 20th century, H1N1 influenza; but contrast with the second major more complicated pandemic, that of HIV/AIDS. The outcomes of these infections are compared, along with seasonal influenza and SARS-1-CoV disease. Work to be done on COVID-19 includes characterisation of the emerging 'long COVID' syndrome, and monitoring the complications of therapies and vaccination programs.

Autopsy in suspected COVID-19 cases.

The severe acute respiratory syndrome (SARS)-coronavirus-2 (CoV-2) outbreak in Wuhan, China has now spread to many countries across the world including the UK with an increasing death toll. This will inevitably lead to an increase in the number of suspected coronavirus disease 2019 (COVID-19)-related deaths at autopsy. The Royal College of Pathologists has responded to this concern with the release of a briefing on autopsy practice relating to COVID-19. The following article is a summary and interpretation of these guidelines. It includes a description of hazard group 3 organisms, the category to which SARS-CoV-2 has been assigned, a brief description of what is currently known about the pathological and autopsy findings in COVID-19, a summary of the recommendations for conducting autopsies in suspected COVID-19 cases and the techniques for making the diagnosis at autopsy. It concludes by considering the clinicopathological correlation and notification of such cases.