HISTOPATHOLOGICAL STUDY OF LUNG CHANGES IN COVID -19 CASES: AUTOPSY STUDY
DOI:
https://doi.org/10.48165/jfmt.2025.42.1.9Keywords:
COVID-19, SARS CoV–2, Medico-legal Autopsy, Lungs, HistopathologyAbstract
A novel coronavirus-severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) hit the world towards the end of 2019. This has caused deaths worldwide. Lungs being the primary site for COVID-19 pathology. We attempt a retrospective histopathology study of the lung changes due to SARS–CoV-2 infection of all the medicolegal autopsies done for covid patients for two years (June 2020 to May 2022). Postmortem lung samples of persons who died due to Covid 19 infection were collected in 10% formalin. A total of 71 cases were studied. Representative bits from the lungs were processed. Histopathology sections were stained with hematoxylin and eosin (H & E) stain and special stains were used as and when required. The gross and microscopic findings were studied. Of these 53 were males (74.64 %) & 18 females (25.35%). The age group of the study population ranged from 23 days to 92 years. The major histopathological findings noted were pulmonary edema, pneumonia, intrapulmonary hemorrhage, chronic phase of diffuse alveolar damage, acute phase of diffuse alveolar damage, subacute phase of diffuse alveolar damage, microthrombi, pneumonia with abscess formation. Acute pneumonia with consolidation was seen in 20 cases (28.1%), intrapulmonary hemorrhage in 15 cases (21.1%), chronic phase of diffuse alveolar damage in 9 cases (12.6%), acute phase of DAD was seen in 7 cases (9.8%), subacute phase in 6 cases (8.4%).References
www.who.int/home/healthtopic/coronavirus
M Angeles Montero Fernandez, Ricardo Pardo-Gracia. Histopathology features of lung in Covid -19 patients, Elsevier public health emergency collection 2021 Mar; 27(3): 123–127.
Louis Maximilian Buja, Dwayne A. Wolf, Bihong Zhao, Bindu Akkanti, Michelle McDonald, Laura Lelenwa, et al. The emerging spectrum of cardiopulmonary pathology of the coronavirus disease 2019 (COVID-19): report of 3 autopsies from Houston, Texas, and review of autopsy findings from other United States cities. Cardiovasc Pathol. 2020; 48:107233.
Fanny Burel-Vandenbos, Nathalie Cardot-Leccia, Thierry Passeron Pulmonary vascular pathology in Covid-19. N Engl J Med. 2020 Aug 27; 383:886–887.
Vishwajit Deshmukh, Rohini Motwani, Ashutosh Kumar, Chiman Kumari, Khursheed Raza. Histopathological observations in COVID-19: A systematic review, J Clin Pathol 2021;74:76–83.
Na Zhu, Ph.D., Dingyu Zhang, M.D., Wenling Wang, Ph.D., Xingwang Li, M.D., Bo Yang, M.S382:727–33.doi:10.1056/NEJMoa2001017 pmid:http://www.ncbi.nlm.nih.gov/pubmed/31978945
Y.Q.Ding, X.W.Bian, Analysis of coronavirus disease -19 (covid -19) based on SARS autopsy. Pathol, 49 (2020), pp.291-293
C.Bryce, Z.Grimes, E.Pujadas, S.ahuja, M.Beth, R.Albrecht et al. Pathophysiology of SARS-C0V-2:targeting of endothelial cells renders a complex disease with thrombotic microangiopathy & aberrant immune response. Mount Sinai Covid -19 Autopsy Experience. medRxiv (2020)
Carsana L, A Sonzogn, A Nasr, Rossi R S, Pellegrinelli A, ZerbiI P, etal. Pulmonary post-mortem findings in a series of COVID -19 cases from northern Italy: a two centre descriptive study. Lancet Infect Diseases. 2020 1-7 August;396(10247):320-332
Benjamin T Bradley, Heather Maioli, Robert Johnston, Irfan Chaudhry, Susan L Fink, Haodong Xu et al. Histopathology and ultrastructural findings of fatal COVID -19 infections in Washington State: a case series. PMC 2020 1-7 August;396 (10247):320-332
Tina Schaller, Klaus Hirschbühl, Katrin Burkhardt, Georg Braun, Martin Trepel, et al. Postmortem examination of patients with COVID 1-19. J Am Med Assoc,323 (2020), pp2518-2520
M.Remmelink, R.De Mendoca, N.D Haene, S.De Clercq, C.Verocq, L.Lebrun, et al. Unspecific postmortem findings despite multiorgan 1 viral spread in COVID -19 patients. medRxiv (2020)
R Aparecida de Almeida Monteiro, A Nunes Duarte-Neto, L Fernando Ferraz da Silva, E Pierre de Oliveira, J Theodoro Filho, G Bento Dos Santos et al. Pulmonary and systemic involvement of COVID -19 assessed by ultra sounded - guided minimally invasive autopsy. Histopathology (2020).10.1111/his.14160
A. Prilutskiy, M. Kritselis, A. Shevtsov et al. SARS-CoV-2 Infection Associated Hemophagocytic Lymphohistiocytosis: an autopsy series with clinical and laboratory correlation. American journal of clinical pathology 154(4),466-467,2020.
Awadhesh Kumar Singh, Ritu Singh, Shashank R Joshi, Anoop Misra, Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India, 2021 July-August; 15(4): 102146.
