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Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy

Background: Mechanisms and causes of death in older patients with SARS-CoV-2 infection are still poorly understood. Methods: We conducted in a retrospective monocentric study, a clinical chart review and post-mortem examination of patients aged 75 years and older hospitalized in acute care and posit...

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Autores principales: Malézieux-Picard, Astrid, Ferrer Soler, Cecilia, De Macedo Ferreira, David, Gaud-Luethi, Emilie, Serratrice, Christine, Mendes, Aline, Zekry, Dina, Gold, Gabriel, Lobrinus, Johannes Alexander, Arnoux, Grégoire, Serra, Fulvia, Prendki, Virginie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037274/
https://www.ncbi.nlm.nih.gov/pubmed/33804890
http://dx.doi.org/10.3390/jcm10071337
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author Malézieux-Picard, Astrid
Ferrer Soler, Cecilia
De Macedo Ferreira, David
Gaud-Luethi, Emilie
Serratrice, Christine
Mendes, Aline
Zekry, Dina
Gold, Gabriel
Lobrinus, Johannes Alexander
Arnoux, Grégoire
Serra, Fulvia
Prendki, Virginie
author_facet Malézieux-Picard, Astrid
Ferrer Soler, Cecilia
De Macedo Ferreira, David
Gaud-Luethi, Emilie
Serratrice, Christine
Mendes, Aline
Zekry, Dina
Gold, Gabriel
Lobrinus, Johannes Alexander
Arnoux, Grégoire
Serra, Fulvia
Prendki, Virginie
author_sort Malézieux-Picard, Astrid
collection PubMed
description Background: Mechanisms and causes of death in older patients with SARS-CoV-2 infection are still poorly understood. Methods: We conducted in a retrospective monocentric study, a clinical chart review and post-mortem examination of patients aged 75 years and older hospitalized in acute care and positive for SARS-CoV-2. Full body autopsy and correlation with clinical findings and suspected causes of death were done. Results: Autopsies were performed in 12 patients (median age 85 years; median of 4 comorbidities, mainly hypertension and cardiovascular disease). All cases showed exudative or proliferative phases of alveolar damage and/or a pattern of organizing pneumonia. Causes of death were concordant in 6 cases (50%), and undetected diagnoses were found in 6. Five patients died from hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19), five had another associated diagnosis and two died from alternative causes. Deaths that occurred in the second week were related to SARS-CoV-2 pneumonia whereas those occurring earlier were related mainly to heart failure and those occurring later to complications. Conclusions: Although COVID-19 hypoxemic respiratory failure was the most common cause of death, post-mortem pathological examination revealed that acute decompensation from chronic comorbidities during the first week of COVID-19 and complications in the third week contributed to mortality.
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spelling pubmed-80372742021-04-12 Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy Malézieux-Picard, Astrid Ferrer Soler, Cecilia De Macedo Ferreira, David Gaud-Luethi, Emilie Serratrice, Christine Mendes, Aline Zekry, Dina Gold, Gabriel Lobrinus, Johannes Alexander Arnoux, Grégoire Serra, Fulvia Prendki, Virginie J Clin Med Article Background: Mechanisms and causes of death in older patients with SARS-CoV-2 infection are still poorly understood. Methods: We conducted in a retrospective monocentric study, a clinical chart review and post-mortem examination of patients aged 75 years and older hospitalized in acute care and positive for SARS-CoV-2. Full body autopsy and correlation with clinical findings and suspected causes of death were done. Results: Autopsies were performed in 12 patients (median age 85 years; median of 4 comorbidities, mainly hypertension and cardiovascular disease). All cases showed exudative or proliferative phases of alveolar damage and/or a pattern of organizing pneumonia. Causes of death were concordant in 6 cases (50%), and undetected diagnoses were found in 6. Five patients died from hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19), five had another associated diagnosis and two died from alternative causes. Deaths that occurred in the second week were related to SARS-CoV-2 pneumonia whereas those occurring earlier were related mainly to heart failure and those occurring later to complications. Conclusions: Although COVID-19 hypoxemic respiratory failure was the most common cause of death, post-mortem pathological examination revealed that acute decompensation from chronic comorbidities during the first week of COVID-19 and complications in the third week contributed to mortality. MDPI 2021-03-24 /pmc/articles/PMC8037274/ /pubmed/33804890 http://dx.doi.org/10.3390/jcm10071337 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Malézieux-Picard, Astrid
Ferrer Soler, Cecilia
De Macedo Ferreira, David
Gaud-Luethi, Emilie
Serratrice, Christine
Mendes, Aline
Zekry, Dina
Gold, Gabriel
Lobrinus, Johannes Alexander
Arnoux, Grégoire
Serra, Fulvia
Prendki, Virginie
Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy
title Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy
title_full Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy
title_fullStr Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy
title_full_unstemmed Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy
title_short Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy
title_sort undetected causes of death in hospitalized elderly with covid-19: lessons from autopsy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037274/
https://www.ncbi.nlm.nih.gov/pubmed/33804890
http://dx.doi.org/10.3390/jcm10071337
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