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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...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2021
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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. |
format | Online Article Text |
id | pubmed-8037274 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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