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COVID-19: Autopsy findings in six patients between 26 and 46 years of age.
Greuel, Selina; Ihlow, Jana; Dragomir, Mihnea-Paul; Streit, Simon; Corman, Victor Max; Haberbosch, Linus; Winkler, David; Meinhardt, Jenny; Aschman, Tom; Schneider, Julia; Trotsyuk, Iryna; Kunze, Catarina Alisa; Maurer, Lukas; Radbruch, Helena; Heppner, Frank L; Horst, David; Elezkurtaj, Sefer.
  • Greuel S; Institute of Pathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
  • Ihlow J; Institute of Pathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany. Electronic address: jana.ihlow@charite.de.
  • Dragomir MP; Institute of Pathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
  • Streit S; Department of Neuropathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
  • Corman VM; Institute of Virology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; German Center for Infection Research (DZIF), 10117 Berlin, Germany.
  • Haberbosch L; Department of Endocrinology and Metabolic Diseases, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
  • Winkler D; Institute of Pathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
  • Meinhardt J; Department of Neuropathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
  • Aschman T; Department of Neuropathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
  • Schneider J; Institute of Virology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; German Center for Infection Research (DZIF), 10117 Berlin, Germany.
  • Trotsyuk I; Institute of Pathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
  • Kunze CA; Institute of Pathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
  • Maurer L; Department of Endocrinology and Metabolic Diseases, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
  • Radbruch H; Department of Neuropathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
  • Heppner FL; Department of Neuropathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; Cluster of Excellence, NeuroCure, 10117 Berlin, Germany; German Center for Neurodegenerative Diseases (DZNE) Berlin, 10117 Berlin, Germany.
  • Horst D; Institute of Pathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
  • Elezkurtaj S; Institute of Pathology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
Int J Infect Dis ; 108: 274-281, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1253010
Semantic information from SemMedBD (by NLM)
1. Fatal Outcome PROCESS_OF Patients
Subject
Fatal Outcome
Predicate
PROCESS_OF
Object
Patients
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. COVID-19 PROCESS_OF Decedent
Subject
COVID-19
Predicate
PROCESS_OF
Object
Decedent
4. Hospital LOCATION_OF C0004398
Subject
Hospital
Predicate
LOCATION_OF
Object
C0004398
5. Real-Time Polymerase Chain Reaction MEASURES RNA
Subject
Real-Time Polymerase Chain Reaction
Predicate
MEASURES
Object
RNA
6. Health care facility LOCATION_OF Autopsy
Subject
Health care facility
Predicate
LOCATION_OF
Object
Autopsy
7. Autopsy ADMINISTERED_TO Patients
Subject
Autopsy
Predicate
ADMINISTERED_TO
Object
Patients
8. Malignant Neoplasms PRECEDES Graft-vs-Host Disease
Subject
Malignant Neoplasms
Predicate
PRECEDES
Object
Graft-vs-Host Disease
9. Thromboembolism PROCESS_OF Cohort
Subject
Thromboembolism
Predicate
PROCESS_OF
Object
Cohort
10. Borg Category-Ratio 10 Perceived Exertion Score 5 PROCESS_OF Patients
Subject
Borg Category-Ratio 10 Perceived Exertion Score 5
Predicate
PROCESS_OF
Object
Patients
11. Immune dysregulation PREDISPOSES Borg Category-Ratio 10 Perceived Exertion Score 5
Subject
Immune dysregulation
Predicate
PREDISPOSES
Object
Borg Category-Ratio 10 Perceived Exertion Score 5
12. Immune dysregulation PREDISPOSES COVID-19
Subject
Immune dysregulation
Predicate
PREDISPOSES
Object
COVID-19
13. Fatal Outcome PROCESS_OF Patients
Subject
Fatal Outcome
Predicate
PROCESS_OF
Object
Patients
14. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
15. COVID-19 PROCESS_OF Decedent
Subject
COVID-19
Predicate
PROCESS_OF
Object
Decedent
16. Hospitals, University LOCATION_OF Autopsy
Subject
Hospitals, University
Predicate
LOCATION_OF
Object
Autopsy
17. Real-Time Polymerase Chain Reaction MEASURES RNA
Subject
Real-Time Polymerase Chain Reaction
Predicate
MEASURES
Object
RNA
18. Health care facility LOCATION_OF Autopsy
Subject
Health care facility
Predicate
LOCATION_OF
Object
Autopsy
19. Autopsy ADMINISTERED_TO Patients
Subject
Autopsy
Predicate
ADMINISTERED_TO
Object
Patients
20. Malignant Neoplasms PRECEDES Graft-vs-Host Disease
Subject
Malignant Neoplasms
Predicate
PRECEDES
Object
Graft-vs-Host Disease
21. Thromboembolism PROCESS_OF Cohort
Subject
Thromboembolism
Predicate
PROCESS_OF
Object
Cohort
22. Borg Category-Ratio 10 Perceived Exertion Score 5 PROCESS_OF Patients
Subject
Borg Category-Ratio 10 Perceived Exertion Score 5
Predicate
PROCESS_OF
Object
Patients
23. Immune dysregulation PREDISPOSES Borg Category-Ratio 10 Perceived Exertion Score 5
Subject
Immune dysregulation
Predicate
PREDISPOSES
Object
Borg Category-Ratio 10 Perceived Exertion Score 5
24. Immune dysregulation PREDISPOSES COVID-19
Subject
Immune dysregulation
Predicate
PREDISPOSES
Object
COVID-19
ABSTRACT

OBJECTIVES:

Studies on coronavirus disease 2019 (COVID-19) usually focus on middle-aged and older adults. However, younger patients may present with severe COVID-19 with potentially fatal outcomes. For optimized, more specialized therapeutic regimens in this particular patient group, a better understanding of the underlying pathomechanisms is of utmost importance.

METHODS:

Our study investigated relevant, pre-existing medical conditions, clinical histories, and autopsy findings, together with SARS-CoV-2-RNA, determined by qPCR, and laboratory data in six COVID-19 decedents aged 50 years or younger, who were autopsied at the Charité University Hospital.

RESULTS:

From a total of 76 COVID-19 patients who underwent an autopsy at our institution, six (7.9%) were 50 years old or younger. Most of these younger COVID-19 decedents presented with pre-existing medical conditions prior to SARS-CoV-2 infection. These included overweight and obesity, arterial hypertension, asthma, and obstructive sleep apnea, as well as graft-versus-host disease following cancer and bone marrow transplantation. Furthermore, clinical histories and autopsy results revealed a disproportionally high prevalence of thromboembolism and ischemic organ damage in this patient cohort. Histopathology and laboratory results indicated coagulopathies, signs of immune dysregulation, and liver damage.

CONCLUSIONS:

In conclusion, pre-existing health conditions may increase the risk of severe and fatal COVID-19 in younger patients, who may be especially prone to developing thromboembolic complications, immune dysregulation, and liver damage.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: COVID-19 / Hypertension Subject: COVID-19 / Hypertension Type of study: Diagnostic study / Risk factors Language: English Journal: Int J Infect Dis Clinical aspect: Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: COVID-19 / Hypertension Subject: COVID-19 / Hypertension Type of study: Diagnostic study / Risk factors Language: English Journal: Int J Infect Dis Clinical aspect: Etiology Year: 2021
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