BackgroundCoronavirus disease-2019 (COVID-19) has caused a great global threat to public health. The World Health Organization (WHO) has declared COVID-19 disease as a pandemic, affecting the human respiratory and other body systems, which urgently demands for better understanding of COVID-19 histopathogenesis.ObjectiveData on pathological changes in different organs are still scarce, thus we aim to review and summarise the latest histopathological changes in different organs observed after autopsy of COVID-19 cases.Materials and methodsOver the period of 3 months, authors performed vast review of the articles. The search engines included were PubMed, Medline (EBSCO & Ovid), Google Scholar, Science Direct, Scopus and Bio-Medical. Search terms used were ‘Histopathology in COVID-19’, ‘COVID-19’, ‘Pathological changes in different organs in COVID-19’ or ‘SARS-CoV-2’. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 guidelines were used for review writing.ResultWe identified various articles related to the histopathology of various organs in COVID-19 positive patients. Overall, 45 articles were identified as full articles to be included in our study. Histopathological findings observed are summarised according to the systems involved.ConclusionAlthough COVID-19 mainly affects respiratory and immune systems, but other systems like cardiovascular, urinary, gastrointestinal tract, reproductive system, nervous system and integumentary system are not spared, especially in elderly cases and those with comorbidity. This review would help clinicians and researchers to understand the tissue pathology, which can help in better planning of the management and avoiding future risks.
Thyroid surgeries are most common neck surgeries; hence thorough knowledge of the blood supply of this gland to the surgeons is of immense importance to prevent any alarming haemorrhage. We report a rare unilateral branching pattern of superior thyroid artery (STA) on right side during routine dissection on an adult male cadaver in the Department of Anatomy, A.I.I.M.S, New Delhi. Left superior thyroid artery was normal. The common trunk (CT) arose from anterior surface of right external carotid artery (ECA) just above the bifurcation of common carotid artery (CCA) soon dividing into five branches i.e., infrahyoid, superior laryngeal, superior thyroid, cricothyroid and sternocleidomastoid artery. This variant branching pattern of STA is very rare. The inferior thyroid arteries did not show any unusual distribution. Knowledge of such arterial variations related to the thyroid gland is immensely helpful to the surgeons to avoid damage of the vital organs in this region.
Placenta is a unique organ which arise de novo, directly related to the growth and development of the foetus in the uterus. A thorough examination of the placenta inutero, as well as post-partum, gives valuable information about the state of the foetal well being. Pregnancy Induced Hypertension is a well recognized obstetric hazard and observed more frequently in developing countries. OBJECTIVES: The present study was undertaken to analyze placental changes in the pregnancy induced hypertension. MATERIAL AND METHODS: thirty placentae of mothers with uncomplicated pregnancy as control group and thirty with pregnancy induced hypertension as study group were studied with gross examination and histologically. RESULTS: Gross examination revealed presence of smaller placentae with foci of calcification and infarction in study group. On light microscopic examination, the striking villous abnormalities were observed in the study group which included increased Syncytial knots formation, fibrinoid necrosis, stromal fibrosis, hyalinized villi, altered villous vascularity (hypo vascularity), cytotrophoblastic cell proliferation, endarteritis obliterans, intervillous haemorrhage and basement membrane thickening. CONCLUSIONS: Pregnancy induced hypertension immensely affected placenta which may be responsible for wore postnatal outcomes. This study is of particular importance for Pathologists, Embryologists and Gynaecologists.
Importance: Higher risks of contracting infection, developing severe illness and mortality are known facts in aged and male sex if exposed to the wild type SARS-CoV-2 strains (Wuhan and B.1 strains). Now, accumulating evidence suggests greater involvement of lower age and narrowing the age and sex based differences for the severity of symptoms in infections with emerging SARS-CoV-2 variants. Delta variant (B.1.617.2) is now a globally dominant SARS-CoV-2 strain, however, current evidence on demographic characteristics for this variant are limited. Recently, delta variant caused a devastating second wave of COVID-19 in India. We performed a demographic characterization of COVID-19 cases in Indian population diagnosed with SARS-CoV-2 genomic sequencing for delta variant. Objective: To determine demographic characteristics of delta variant in terms of age and sex, severity of the illness and mortality rate, and post-vaccination infections. Design: A cross sectional study Setting: Demographic characteristics, including vaccination status (for two complete doses) and severity of the illness and mortality rate, of COVID-19 cases caused by wild type strain (B.1) and delta variant (B.1.617.2) of SARS-CoV-2 in Indian population were studied. Participants: COVID-19 cases for which SARS-CoV-2 genomic sequencing was performed and complete demographic details (age, sex, and location) were available, were included. Exposures: SARS-CoV-2 infection with Delta (B.1.617.2) variant and wild type (B.1) strain. Main Outcomes and Measures: The patient metadata containing details for demographic and vaccination status (two complete doses) of the COVID-19 patients with confirmed delta variant and WT (B.1) infections were analyzed [total number of cases (N) =9500, NDelta =6238, NWT=3262]. Further, severity of the illness and mortality were assessed in subsets of patients. Final data were tabulated and statistically analyzed to determine age and sex based differences in chances of getting infection and the severity of illness, and post-vaccination infections were compared between wild type and delta variant strains. Graphs were plotted to visualize the trends. Results: With delta variant, in comparison to wild type (B.1) strain, higher proportion of young age individuals (<20 year) (0-9 year: 4.47% vs. 2.3%, 10-19 year: 9% vs. 7%) were affected. The proportion of women contracting infection were increased (41% vs. 36%). The higher proportion of total young (0-19 year, 10% vs. 4%) (p=.017) population and young (14% vs. 3%) as well as adult (20-59 year, 75% vs. 55%) women developed symptoms/hospitalized with delta variant in comparison to B.1 infection (p< .00001). The mean age of contracting infection [Delta, men=37.9 (17.2) year, women=36.6 (17.6) year; B.1, men=39.6 (16.9) year and women= 40.1 (17.4) year (p<.001)] as well as developing symptoms/hospitalization [Delta, men=39.6(17.4) year, women=35.6(16.9) year; B.1, men=47(18) year and women= 49.5(20.9) year (p<.001)] was considerably lower. The total mortality was about 1.8 times higher (13% vs. 7%). Risk of death increased irrespective of the sex (Odds ratio: 3.034, 95% Confidence Interval: 1.7-5.2, p<0.001), however, increased proportion of women (32% vs. 25%) were demised. Further, multiple incidences of delta infections were noted following complete vaccination. Conclusions and Relevance: The increased involvement of young (0-19 year) and women, lower mean age for contracting infection and symptomatic illness/hospitalization, higher mortality, and frequent incidences of post-vaccination infections with delta variant compared to wild type strain raises significant epidemiological concerns.
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