DOI: https://doi.org/10.22263/2312-4156.2020.3.41
Samsonava I.V.1, Liasnichaya O.V.1, Malashenka S.V.2, Klopava V.A.1, Galipad V.V.2, Mliavy A.M.2
Pathomorphology of COVID-19 according to the data of fifteen autopsies
1Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
2Vitebsk Regional Clinical Pathoanatomical Bureau, Vitebsk, Republic of Belarus
Vestnik VGMU. 2020;19(3):41-49.
Abstract.
Objectives. To study the morphological changes in the organism of patients who died from coronavirus infection and to assess the pathogenetic role of the lung damage in the development of respiratory failure.
Material and methods. An autopsy study of 15 patients with diagnosed SARS-CoV-2, who died over a period of March, 16 – April, 15 was performed. Autopsy samples of the lungs and other organs were investigated by standard morphological and immunohistochemical methods.
In 13 lungs specimens characteristic changes in the airborne barrier with the damage of the alveolar epithelium, edema, swelling, cleavage of the basal membranes, and interstitial inflammatory infiltration were found. In most cases the PAS-positive hyaline membranes were observed in the alveoli, alveolar ducts and bronchioles. The lumen of the respiratory parts of the lungs contained multinucleated giant epithelial cells, desquamated atypical enlarged alveolocytes with large polymorphic nuclei, amphophilic granular cytoplasm, well defined intranuclear and / or intracytoplasmic inclusions, prominent nucleoli, accumulations of red blood cells, locally marked, alveolar macrophages, transudate, fibrin. An immunohistochemical study of Ki-67 and CD 34 markers demonstrated an increase in their expression.
Conclusions. Presumably, the revealed changes are a consequence of viral and leukocyte aggression and are the basis for further progression of the disease and its complications.
Key words: SARS-CoV-2, autopsy, COVID-19 pathomorphology, immunohistochemistry, Ki-67, CD 34.
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Information about authors:
Samsonava I.V. – Candidate of Medical Sciences, associate professor, head of the Chair of Pathologic Anatomy with the course of Forensic Medicine, Vitebsk State Order of Peoples’ Friendship Medical University;
Liasnichaya O.V. – Candidate of Medical Sciences, associate professor of the Chair of Pathologic Anatomy with the course of Forensic Medicine, Vitebsk State Order of Peoples’ Friendship Medical University;
Malashenka S.V. – Candidate of Medical Sciences, associate professor, director of Vitebsk Regional Clinical Pathoanatomical Bureau;
Klopava V.A. – Candidate of Medical Sciences, associate professor of the Chair of Pathologic Anatomy with the course of Forensic Medicine, Vitebsk State Order of Peoples’ Friendship Medical University;
Galipad V.V. – head of infections pathology department, Vitebsk Regional Clinical Pathoanatomical Bureau;
Mliavy A.M. – pathoanatomist, Vitebsk Regional Clinical Pathoanatomical Bureau;
Correspondence address: Republic of Belarus, 210009, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Pathologic Anatomy with the course of Forensic Medicine. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Ina V. Samsonava.
