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Pathological findings in COVID-19: A conventional autopsy-based study from India.
Kyada, Hetal C; Bhalara, Rohit V; Vadgama, Divyesh K; Varu, Pratik R; Trangadia, Mahesh M; Manvar, Prince J; Bhuva, Shailesh D.
  • Kyada HC; Department of Forensic Medicine, Pandit Deendayal Upadhyay Government Medical College, Civil Hospital Campus, Rajkot, Gujarat, India.
  • Bhalara RV; Department of Pathology, Pandit Deendayal Upadhyay Government Medical College, Civil Hospital Campus, Rajkot, Gujarat, India.
  • Vadgama DK; Department of Forensic Medicine, Pandit Deendayal Upadhyay Government Medical College, Civil Hospital Campus, Rajkot, Gujarat, India.
  • Varu PR; Department of Forensic Medicine, Pandit Deendayal Upadhyay Government Medical College, Civil Hospital Campus, Rajkot, Gujarat, India.
  • Trangadia MM; Department of Forensic Medicine, Pandit Deendayal Upadhyay Government Medical College, Civil Hospital Campus, Rajkot, Gujarat, India.
  • Manvar PJ; Department of Forensic Medicine, Pandit Deendayal Upadhyay Government Medical College, Civil Hospital Campus, Rajkot, Gujarat, India.
  • Bhuva SD; Department of Forensic Medicine, Pandit Deendayal Upadhyay Government Medical College, Civil Hospital Campus, Rajkot, Gujarat, India.
Indian J Med Res ; 155(1): 178-188, 2022 01.
Article in English | MEDLINE | ID: covidwho-2201748
ABSTRACT
Background &

objectives:

Autopsy study has been considered the gold standard method for studying the effects of any disease on the body. Since COVID-19 is a novel disease, autopsy is crucial to understand its pathophysiology. This study was conducted to analyze the microscopic and macroscopic findings of various organs in COVID-19 and to associate those findings with clinical observations and laboratory findings.

Methods:

Conventional invasive autopsies were performed on 33 patients with COVID-19 from September 7, 2020 to December 23, 2020. All the organs were removed by routine dissection techniques and preserved in 10 per cent formalin. The tissues were processed and stained according to standard practices using haematoxylin-eosin (H & E) and periodic acid-schiff (PAS) stain.

Results:

The study included 28 males and 5 females with a median age of 61 yr (range 30-90 yr). Massive pulmonary oedema and thrombi in the lungs were the characteristic features macroscopically. On microscopic examination, diffuse alveolar damage in the exudative/proliferative phase was found in 29 (87.88%) cases. Among the other notable microscopic findings were bronchopneumonia and lung abscesses due to secondary bacterial infection (n=17, 51.52%), acute tubular injury (n=21, 63.64%) and thrombi in the lungs, heart, and kidneys. Interpretation &

conclusions:

COVID-19 primarily affected the respiratory and the renal systems in the vast majority of severely affected patients in our study. We also found signs of hypercoagulability, as evidenced by widespread thrombi in multiple organs, along with a raised d-dimer level and a hyperinflammatory state manifested by elevated inflammatory markers. Our autopsy findings and altered laboratory investigations support the role of immune-mediated cellular injury along with direct virus-mediated cellular damage.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombosis / COVID-19 Type of study: Observational study / Prognostic study Limits: Female / Humans / Male Country/Region as subject: Asia Language: English Journal: Indian J Med Res Year: 2022 Document Type: Article Affiliation country: Ijmr.IJMR_677_21

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombosis / COVID-19 Type of study: Observational study / Prognostic study Limits: Female / Humans / Male Country/Region as subject: Asia Language: English Journal: Indian J Med Res Year: 2022 Document Type: Article Affiliation country: Ijmr.IJMR_677_21