Late histopathologic characteristics of critically ill COVID-19 patients: Different phenotypes without evidence of invasive aspergillosis, a case series.
J Crit Care
; 59: 149-155, 2020 10.
Article
in English
| MEDLINE | ID: covidwho-635492
ABSTRACT
PURPOSE:
Pathological data of critical ill COVID-19 patients is essential in the search for optimal treatment options. MATERIAL ANDMETHODS:
We performed postmortem needle core lung biopsies in seven patients with COVID-19 related ARDS. Clinical, radiological and microbiological characteristics are reported together with histopathological findings. MEASUREMENT AND MAINRESULTS:
Patients age ranged from 58 to 83 years, five males and two females were included. Time from hospital admission to death ranged from 12 to 36 days, with a mean of 20 ventilated days. ICU stay was complicated by pulmonary embolism in five patients and positive galactomannan on bronchoalveolar lavage fluid in six patients, suggesting COVID-19 associated pulmonary aspergillosis. Chest CT in all patients showed ground glass opacities, commonly progressing to nondependent consolidations. We observed four distinct histopathological patterns acute fibrinous and organizing pneumonia, diffuse alveolar damage, fibrosis and, in four out of seven patients an organizing pneumonia. None of the biopsy specimens showed any signs of invasive aspergillosis.CONCLUSIONS:
In this case series common late histopathology in critically ill COVID patients is not classic DAD but heterogeneous with predominant pattern of organizing pneumonia. Postmortem biopsy investigations in critically COVID-19 patients with probable COVID-19 associated pulmonary aspergillosis obtained no evidence for invasive aspergillosis.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Respiratory Distress Syndrome
/
Lung Diseases, Interstitial
/
Coronavirus Infections
/
Pulmonary Aspergillosis
/
Lung
Type of study:
Prognostic study
Topics:
Long Covid
Language:
English
Journal:
J Crit Care
Journal subject:
Critical Care
Year:
2020
Document Type:
Article
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