Abstract
Objective: To study the impact of age and the interval between
disease diagnosis and
death on the
organotropism of
SARS-CoV-2 .
Method: Patients underwent post-mortem
biopsies from
lungs , Waldeyer ring,
heart ,
liver ,
kidneys and
bone marrow between 2020-2021.
SARS-CoV-2 organotropism was mapped by using molecular RT-PCR analyses for SARS-CoV2 targeting the Envelope
gene (E), the
RNA Polymerase Gene (RdRp), and the
Nucleocapsid gene (N). Statistical and
linear regression analysis was performed to study the impact of age and illness duration in
SARS-CoV-2 organotropism .
Results: We performed 158 postmortem
biopsies in 21
patients , with a mean age of 76 years old. The mean interval between the
diagnosis of the
infection to the
death was 23 days. The
RNA of the
SARS-CoV-2 was detected in 100% of
lung biopsies , 76%-82% of Waldeyer's ring
biopsies , 55% of
heart biopsies , 40% of
kidney biopsies , 33% of
liver and 25% of
bone marrow biopsies .
Patients who died before the day 9, presented extensive visceral dissemination of
SARS-CoV-2 RNA . Most of the
patients older than 80 years (90%) presented visceral dissemination of
SARS-CoV-2 RNA , while among younger
patients , only 3/11
patients presented visceral dissemination of the
virus . The relationship between "age" and "illness duration" and multitropism of the
virus was statistically significant (p< 0.001).
Conclusion: Disease interval and age were factors that were significantly associated with RT-PCR positive results in multiple organs. Critical COVID-19
patients have multiorganic viral dissemination in early stages. In the critical older
patients , multiorganic viral dissemination is the rule. Level of evidence 4. Case Series.