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Clinicopathologic characteristics of severe COVID-19 patients in Mexico City: A post-mortem analysis using a minimally invasive autopsy approach

OBJECTIVE: 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. DESIGN: Observational post-mortem cohort study. Minimally invasive ultrasound-guided autopsies were perfor...

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Autores principales: Nava-Santana, Carlos, Rodríguez-Armida, María, Jiménez, José Víctor, Vargas-Parra, Nancy, León, Diana E. Aguilar, Campos-Murguia, Alejandro, Macías-Rodriguez, Ricardo, Arteaga-Garrido, Andrés, Hernández-Villegas, Antonio C., Dominguez-Cherit, Guillermo, Rivero-Sigarroa, Eduardo, Gamboa-Dominguez, Armando, Gullias-Herrero, Alfonso, Sifuentes-Osornio, José, Uribe-Uribe, Norma Ofelia, Morales-Buenrostro, Luis E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8893646/
https://www.ncbi.nlm.nih.gov/pubmed/35239660
http://dx.doi.org/10.1371/journal.pone.0262783
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author Nava-Santana, Carlos
Rodríguez-Armida, María
Jiménez, José Víctor
Vargas-Parra, Nancy
León, Diana E. Aguilar
Campos-Murguia, Alejandro
Macías-Rodriguez, Ricardo
Arteaga-Garrido, Andrés
Hernández-Villegas, Antonio C.
Dominguez-Cherit, Guillermo
Rivero-Sigarroa, Eduardo
Gamboa-Dominguez, Armando
Gullias-Herrero, Alfonso
Sifuentes-Osornio, José
Uribe-Uribe, Norma Ofelia
Morales-Buenrostro, Luis E.
author_facet Nava-Santana, Carlos
Rodríguez-Armida, María
Jiménez, José Víctor
Vargas-Parra, Nancy
León, Diana E. Aguilar
Campos-Murguia, Alejandro
Macías-Rodriguez, Ricardo
Arteaga-Garrido, Andrés
Hernández-Villegas, Antonio C.
Dominguez-Cherit, Guillermo
Rivero-Sigarroa, Eduardo
Gamboa-Dominguez, Armando
Gullias-Herrero, Alfonso
Sifuentes-Osornio, José
Uribe-Uribe, Norma Ofelia
Morales-Buenrostro, Luis E.
author_sort Nava-Santana, Carlos
collection PubMed
description OBJECTIVE: 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. DESIGN: 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. SETTING: Single-center COVID-19 reference center in Mexico City. RESULTS: 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. CONCLUSION: 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.
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spelling pubmed-88936462022-03-04 Clinicopathologic characteristics of severe COVID-19 patients in Mexico City: A post-mortem analysis using a minimally invasive autopsy approach Nava-Santana, Carlos Rodríguez-Armida, María Jiménez, José Víctor Vargas-Parra, Nancy León, Diana E. Aguilar Campos-Murguia, Alejandro Macías-Rodriguez, Ricardo Arteaga-Garrido, Andrés Hernández-Villegas, Antonio C. Dominguez-Cherit, Guillermo Rivero-Sigarroa, Eduardo Gamboa-Dominguez, Armando Gullias-Herrero, Alfonso Sifuentes-Osornio, José Uribe-Uribe, Norma Ofelia Morales-Buenrostro, Luis E. PLoS One Research Article OBJECTIVE: 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. DESIGN: 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. SETTING: Single-center COVID-19 reference center in Mexico City. RESULTS: 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. CONCLUSION: 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. Public Library of Science 2022-03-03 /pmc/articles/PMC8893646/ /pubmed/35239660 http://dx.doi.org/10.1371/journal.pone.0262783 Text en © 2022 Nava-Santana et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Nava-Santana, Carlos
Rodríguez-Armida, María
Jiménez, José Víctor
Vargas-Parra, Nancy
León, Diana E. Aguilar
Campos-Murguia, Alejandro
Macías-Rodriguez, Ricardo
Arteaga-Garrido, Andrés
Hernández-Villegas, Antonio C.
Dominguez-Cherit, Guillermo
Rivero-Sigarroa, Eduardo
Gamboa-Dominguez, Armando
Gullias-Herrero, Alfonso
Sifuentes-Osornio, José
Uribe-Uribe, Norma Ofelia
Morales-Buenrostro, Luis E.
Clinicopathologic characteristics of severe COVID-19 patients in Mexico City: A post-mortem analysis using a minimally invasive autopsy approach
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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8893646/
https://www.ncbi.nlm.nih.gov/pubmed/35239660
http://dx.doi.org/10.1371/journal.pone.0262783
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