Clinicopathologic Features of COVID-19: A Case Report and Value of Forensic Autopsy in Studying SARS-CoV-2 Infection.

Abstract

ABSTRACT:

As of August 23, 2020, the 2019 novel coronavirus disease (COVID-19) has infected more than 23,518,340 people and caused more than 810,492 deaths worldwide including 4,717 deaths in China. We present a case of a 53-year-old woman who was admitted to the hospital because of dry coughs and high fever on January 26, 2020, in Wuhan, China. She was not tested for SARS-CoV-2 RNA until on hospital day 11 (illness day 21) because of a significant shortage of test kits at the local hospital. Then, her test was positive for COVID-19 on hospital day 20. Despite intensive medical treatments, she developed respiratory failure with secondary bacterial infection and expired on hospital day 23 (3 days after she was tested positive for SARS-CoV-2 RNA). A systemic autopsy examination, including immunohistochemistry and ultrastructural studies, demonstrates that SARS-CoV-2 can infect multiple organs with profound adverse effect on the immune system, and the lung pathology is characterized by diffuse alveolar damage. Extrapulmonary SARS-CoV-2 RNA was detected in several organs postmortem. The detailed pathological features are described. In addition, this report highlights the value of forensic autopsy in studying SARS-CoV-2 infection and the importance of clinicopathological correlation in better understanding the pathogenesis of COVID-19.

• Authors: Liang Ren, Qian Liu, Rongshuai Wang, Rong Chen, Qilin Ao, Xi Wang, Jie Zhang, Fei Deng, Yan Feng, Guoping Wang, Yiwu Zhou, Ling Li, Liang Liu
• Journal: The American journal of forensic medicine and pathology (Am J Forensic Med Pathol) Vol. 42 Issue 2 Pg. 164-169 (Jun 01 2021) ISSN: 1533-404X [Electronic] United States
• PMID: 33464756 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Chemical References

• RNA, Viral

Topics

• Autopsy
• COVID-19 (diagnosis)
• Epiglottitis (pathology)
• Female
• Fibroblasts (pathology)
• Humans
• Infarction (pathology)
• Intracranial Thrombosis (pathology)
• Kidney (blood supply, pathology)
• Lung (pathology)
• Lymph Nodes (pathology)
• Lymphocytes (pathology)
• Middle Aged
• Myocytes, Cardiac (pathology)
• Myofibroblasts (pathology)
• Necrosis
• RNA, Viral (analysis)
• Splenic Infarction (pathology)
• Subarachnoid Hemorrhage (pathology)
• Thromboembolism (pathology)
• Thrombosis (pathology)
• Thyroiditis, Autoimmune (pathology)
• Urinary Bladder (pathology)