Pulmonary histopathological findings in Covid-19 patients: based on minimally invasive autopsies Hallazgos histopatológicos pulmonares en COVID-19. Experiencia de autopsias mínimamente invasivas

Abstract

Introduction: COVID-19 is caused by the SARS-CoV-2 virus. Its clinical presentation varies from asymptomatic patients to severe manifestations. During the pandemic, autopsies have allowed the recognition of changes in different organs, with the lung being the main affected organ. The aim of this study is reporting our experience derived from pulmonary histopathological findings, based on the minimally invasive autopsy method. Methodology: samples were taken in the immediate postmortem (one hour) period from 8 patients who died with PCR-confirmed COVID-19, in the intensive care unit (ICU) of Hospital de San José, Bogotá, Colombia.  Tissue specimens were analyzed independently by two pathologists. Results: all specimens exhibited, diffuse alveolar damage (DAD) in exudative or proliferative phases, or both, in addition to bronchopneumonia and interstitial pneumonitis. Discussion: the lung is the main organ affected by SARS-CoV-2 and the most frequent histopathologic finding is exudative phase or various phases DAD. Alterations in different systems have also been described. Conclusions: the most frequent histopathological finding is DAD in any of its phases. Minimally invasive autopsy is considered a very useful alternative when conventional autopsy cannot be performed, since it does not have major restrictions and allows collecting viable samples.