Clinicopathologic characteristics of severe COVID-19 patients in Mexico City: A post-mortem analysis using a minimally invasive autopsy approach.
<h4>Objective</h4>Describe the histological findings of minimally ultrasound-guided invasive autopsies in deceased patients with severe SARS-CoV-2 and compare the diagnostic yield with open autopsies.<h4>Design</h4>Observational post-mortem cohort study. Minimally invasive ul...
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2022-01-01
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| author | Carlos Nava-Santana María Rodríguez-Armida José Víctor Jiménez Nancy Vargas-Parra Diana E Aguilar León Alejandro Campos-Murguia Ricardo Macías-Rodriguez Andrés Arteaga-Garrido Antonio C Hernández-Villegas Guillermo Dominguez-Cherit Eduardo Rivero-Sigarroa Armando Gamboa-Dominguez Alfonso Gullias-Herrero José Sifuentes-Osornio Norma Ofelia Uribe-Uribe Luis E Morales-Buenrostro |
| author_facet | Carlos Nava-Santana María Rodríguez-Armida José Víctor Jiménez Nancy Vargas-Parra Diana E Aguilar León Alejandro Campos-Murguia Ricardo Macías-Rodriguez Andrés Arteaga-Garrido Antonio C Hernández-Villegas Guillermo Dominguez-Cherit Eduardo Rivero-Sigarroa Armando Gamboa-Dominguez Alfonso Gullias-Herrero José Sifuentes-Osornio Norma Ofelia Uribe-Uribe Luis E Morales-Buenrostro |
| author_sort | Carlos Nava-Santana |
| collection | DOAJ |
| description | <h4>Objective</h4>Describe the histological findings of minimally ultrasound-guided invasive autopsies in deceased patients with severe SARS-CoV-2 and compare the diagnostic yield with open autopsies.<h4>Design</h4>Observational post-mortem cohort study. Minimally invasive ultrasound-guided autopsies were performed in fourteen deceased patients with a confirmed diagnosis of SARS-CoV-2 pneumonia. Histological and clinical findings of lung, kidney, and liver tissue are described and contrasted with those previously reported in the literature.<h4>Setting</h4>Single-center COVID-19 reference center in Mexico City.<h4>Results</h4>Fourteen minimally invasive autopsies revealed a gross correlation with open autopsies reports: 1) Lung histology was characterized mainly by early diffuse alveolar damage (12/13). Despite low lung compliances and prolonged mechanical ventilation, the fibrotic phase was rarely observed (2/13). 2) Kidney histopathology demonstrated acute tubular injury (12/13), interstitial nephritis (11/13), and glomerulitis (11/13) as the predominant features 3) Liver histology was characterized by neutrophilic inflammation in all of the cases, as well as hepatic necrosis (8/14) despite minimal alterations in liver function testing. Hepatic steatosis was observed in most cases (12/14). SARS-CoV-2 positivity was widely observed throughout the immunohistochemical analysis. However, endothelitis and micro thrombosis, two of the hallmark features of the disease, were not observed.<h4>Conclusion</h4>Our data represents the largest minimally invasive, ultrasound-guided autopsy report. We demonstrate a gross histological correlation with large open autopsy cohorts. However, this approach might overlook major histologic features of the disease, such as endothelitis and micro-thrombosis. Whether this represents sampling bias is unclear. |
| format | Article |
| id | doaj-art-f28a1ea697a24e0a9f3b6bb068ed039d |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-f28a1ea697a24e0a9f3b6bb068ed039d2025-08-20T03:16:29ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01173e026278310.1371/journal.pone.0262783Clinicopathologic characteristics of severe COVID-19 patients in Mexico City: A post-mortem analysis using a minimally invasive autopsy approach.Carlos Nava-SantanaMaría Rodríguez-ArmidaJosé Víctor JiménezNancy Vargas-ParraDiana E Aguilar LeónAlejandro Campos-MurguiaRicardo Macías-RodriguezAndrés Arteaga-GarridoAntonio C Hernández-VillegasGuillermo Dominguez-CheritEduardo Rivero-SigarroaArmando Gamboa-DominguezAlfonso Gullias-HerreroJosé Sifuentes-OsornioNorma Ofelia Uribe-UribeLuis E Morales-Buenrostro<h4>Objective</h4>Describe the histological findings of minimally ultrasound-guided invasive autopsies in deceased patients with severe SARS-CoV-2 and compare the diagnostic yield with open autopsies.<h4>Design</h4>Observational post-mortem cohort study. Minimally invasive ultrasound-guided autopsies were performed in fourteen deceased patients with a confirmed diagnosis of SARS-CoV-2 pneumonia. Histological and clinical findings of lung, kidney, and liver tissue are described and contrasted with those previously reported in the literature.<h4>Setting</h4>Single-center COVID-19 reference center in Mexico City.<h4>Results</h4>Fourteen minimally invasive autopsies revealed a gross correlation with open autopsies reports: 1) Lung histology was characterized mainly by early diffuse alveolar damage (12/13). Despite low lung compliances and prolonged mechanical ventilation, the fibrotic phase was rarely observed (2/13). 2) Kidney histopathology demonstrated acute tubular injury (12/13), interstitial nephritis (11/13), and glomerulitis (11/13) as the predominant features 3) Liver histology was characterized by neutrophilic inflammation in all of the cases, as well as hepatic necrosis (8/14) despite minimal alterations in liver function testing. Hepatic steatosis was observed in most cases (12/14). SARS-CoV-2 positivity was widely observed throughout the immunohistochemical analysis. However, endothelitis and micro thrombosis, two of the hallmark features of the disease, were not observed.<h4>Conclusion</h4>Our data represents the largest minimally invasive, ultrasound-guided autopsy report. We demonstrate a gross histological correlation with large open autopsy cohorts. However, this approach might overlook major histologic features of the disease, such as endothelitis and micro-thrombosis. Whether this represents sampling bias is unclear.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0262783&type=printable |
| spellingShingle | Carlos Nava-Santana María Rodríguez-Armida José Víctor Jiménez Nancy Vargas-Parra Diana E Aguilar León Alejandro Campos-Murguia Ricardo Macías-Rodriguez Andrés Arteaga-Garrido Antonio C Hernández-Villegas Guillermo Dominguez-Cherit Eduardo Rivero-Sigarroa Armando Gamboa-Dominguez Alfonso Gullias-Herrero José Sifuentes-Osornio Norma Ofelia Uribe-Uribe Luis E Morales-Buenrostro Clinicopathologic characteristics of severe COVID-19 patients in Mexico City: A post-mortem analysis using a minimally invasive autopsy approach. PLoS ONE |
| title | Clinicopathologic characteristics of severe COVID-19 patients in Mexico City: A post-mortem analysis using a minimally invasive autopsy approach. |
| title_full | Clinicopathologic characteristics of severe COVID-19 patients in Mexico City: A post-mortem analysis using a minimally invasive autopsy approach. |
| title_fullStr | Clinicopathologic characteristics of severe COVID-19 patients in Mexico City: A post-mortem analysis using a minimally invasive autopsy approach. |
| title_full_unstemmed | Clinicopathologic characteristics of severe COVID-19 patients in Mexico City: A post-mortem analysis using a minimally invasive autopsy approach. |
| title_short | Clinicopathologic characteristics of severe COVID-19 patients in Mexico City: A post-mortem analysis using a minimally invasive autopsy approach. |
| title_sort | clinicopathologic characteristics of severe covid 19 patients in mexico city a post mortem analysis using a minimally invasive autopsy approach |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0262783&type=printable |
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