Clinical and laboratory manifestations and pathological anatomical picture of a severe course of a new coronavirus infection COVID-19 with a fatal outcome

Aim - to study the clinical and laboratory manifestations of a severe course of COVID-19 in a lethal outcome with an assessment of the pathomorphological picture based on autopsy material. Material and methods. A retrospective analysis of demographic, clinical and laboratory parameters, as well as the results of a pathoanatomical study of 54 patients with severe COVID-19 who died in the intensive care unit, was carried out. Results. Among the patients included in the study, women and men were equally divided. The mean age was 73.1+/-1.86 years (median 73 years). An increase in body temperature above 38 degreeS was observed in 81.5% of cases, weakness - in 70.4%, dry cough - in 46.3%, a feeling of lack of air - in 46.3%, muscle pain - in 40.7%. The volume of lung damage by the type of bilateral polysegmental pneumonia with areas of compaction of the type of "frosted glasses" and consolidation was more than 75.0% and was determined in 68.5% of patients. Concomitant diseases were detected in 94.4% of patients. It was found that all patients had a pronounced systemic inflammatory response, as evidenced by an increase in the level of C-reactive protein and procalcitonin in all patients. A decrease in albumin levels was observed in 88.9% of cases. A hypercoagulable shift with intravascular coagulation was noted. Morphological studies revealed damage to the lungs, liver, kidneys and pancreas with the development of thrombovascular changes. Conclusion. A severe course of COVID-19 with a fatal outcome was observed in older patients with clinical, radiological and laboratory manifestations of a systemic inflammatory response, which was accompanied by damage to various organs and systems.Copyright © Authors, 2022.

[Lymphocytic myocarditis in patients with COVID-19 (4 autopsy cases)]. / Limfotsitarnyi miokardit u patsientov s COVID-19 (4 autopsiinykh nablyudeniya).

The paper describes 4 autopsy cases of myocarditis in elderly patients with confirmed coronavirus infection. It gives the data of a morphological study of heart specimens and a detailed characterization of a myocardial infiltrate. An immunohistochemical study with cellular infiltrate typing was performed. The fact that lymphocytic viral myocarditis can develop in COVID-19 was morphologically and immunohistochemically confirmed. The features of myocarditis in COVID-19 are the development of the former in the presence of coronaritis and the possibility of its concurrence with lymphocytic endo- and pericarditis.