The spectrum of pathological findings in coronavirus disease (COVID-19) and the pathogenesis of SARS-CoV-2

• Published in: Diagnostic pathology Vol. 15; no. 1; p. 85
• Main Authors: Barth, Rolf F, Buja, L Maximillian, Parwani, Anil V
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 14-07-2020; BioMed Central; BMC
• Subjects: Autopsies; Autopsy; Betacoronavirus; Bronchopneumonia; Coronavirus Infections - pathology; Coronavirus Infections - physiopathology; Coronaviruses; COVID-19; Damping; Development and progression; Dexamethasone; Exudation; Fatalities; Health aspects; Humans; Inflammation; Inflammatory response; Medical research; Morbidity; Pandemics; Pathogenesis; Pathology; Pneumonia, Viral - pathology; Pneumonia, Viral - physiopathology; Respiratory diseases; Respiratory distress syndrome; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Thromboembolism; Viral diseases; World health; China
• ISSN: 1746-1596; 1746-1596
• DOI: 10.1186/s13000-020-00999-9

Most of the symptomatic patients have mild flu-like features but a significant subset develop a bronchopneumonia, which clinically is the acute respiratory distress syndrome (ARDS), and leads to significant morbidity and mortality [3]. [...]of this writing in late June and to the best of our knowledge, there have been at least 13 reports describing autopsy findings in approximately 250 decedents who have succumbed to COVID-19 [4, 12,13,14,15,16,17,18,19,20,21,22] In the meantime, as of June 15, 2020, the number of confirmed cases has climbed to over 2.1 million and over 115,000 deaths in the United States and 8 million cases and more than 440,000 deaths worldwide. [...]the total number of autopsies performed is miniscule compared to the number of deaths, but nevertheless they are both very revealing and important in order to better understand the multi-organ involvement associated with COVID-19 infection and for the development of better treatment strategies [1, 3]. Acute severe COVID-19 respiratory disease develops as a severe acute respiratory distress syndrome (ARDS) that autopsy studies have shown to be related to an underlying severe form of DAD in the acute, exudative phase. Consensus guidelines are now available for prevention, antithrombotic therapy, and follow-up for thrombotic and thromboembolic disease in COVID-19 patients [30] and the damping of the hyperimmune inflammatory response by the administration of Dexamethasone [31].