Autopsy of COVID-19 patients in China

Bian, Xiu‐Wu; Yao, Xiaohong; Ping, Yi‐Fang; Yu, Shanshan; Shi, Yu; Luo, Tao; He, Zhicheng; Tang, Rui; Chen, Cong; Fu, Wen-Juan; Zhang, Hongyan; Zhang, Huarong; Xiang, Dongfang; Li, Qingrui; Huang, Xuequan; Li, Tingyuan; Zhao, Pengnan; Wang, Chaofu; Fei, Xiaochun; Cai, Jun; Zhao, Lei; Zhang, Heng; Liu, Zhenghua; Liu, Liang; Wang, Guoping; Nie, Xiu; Zhou, Yiwu; Ren, Liang; Liu, Qian; Wang, Yi; Ao, Qilin; Wang, Xi; Duan, Yaqi; Li, Jiansha; Xiong, Ji; Xu, Sanpeng; Zhang, Jie; Huang, Shu; Yang, Ming; Huang, Bo; Li, Xiang; Peng, Lixu; Xi, Peng; Xiong, Hua; Su, Hua; Wangcheng, Sihua; Yu, Cheng; Wu, Haibo; Li, Heng; Ren, Yong; Chen, Xinwei; Liwei, Liang; Zhang, Zongxing; Chen, Rong; Deng, Fei; Qu, Guoqiang; Wang, Rongshuai; Wang, Yunyun; Zhou, Xiaowei; Wang, Fusheng; Zhao, Jingmin

doi:10.1093/nsr/nwaa123

Cited by 122 publications

(138 citation statements)

References 4 publications

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“…1,3 It is likely that aberrant and excessive immune responses evoked by SARS-CoV-2 infection in the host are involved in the pathogenesis of lung and multi-organ injury. 4,5 To date, no specific antivirals have proven to be effective to treat COVID-19 and the management of patients with COVID-19 remains largely supportive, with organ support when necessary. Thus, deaths from COVID-19 will continue to rise globally until new effective therapeutics are developed and evaluated in clinical trials.…”

Section: Introductionmentioning

confidence: 99%

Human umbilical cord-derived mesenchymal stem cell therapy in patients with COVID-19: a phase 1 clinical trial

Meng

Wang

et al. 2020

Sig Transduct Target Ther

253

201

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No effective drug treatments are available for coronavirus disease 2019 (COVID-19). Host-directed therapies targeting the underlying aberrant immune responses leading to pulmonary tissue damage, death, or long-term functional disability in survivors require clinical evaluation. We performed a parallel assigned controlled, non-randomized, phase 1 clinical trial to evaluate the safety of human umbilical cord-derived mesenchymal stem cells (UC-MSCs) infusions in the treatment of patients with moderate and severe COVID-19 pulmonary disease. The study enrolled 18 hospitalized patients with COVID-19 (n = 9 for each group). The treatment group received three cycles of intravenous infusion of UC-MSCs (3 × 10 7 cells per infusion) on days 0, 3, and 6. Both groups received standard COVID-treatment regimens. Adverse events, duration of clinical symptoms, laboratory parameters, length of hospitalization, serial chest computed tomography (CT) images, the PaO 2 /FiO 2 ratio, dynamics of cytokines, and IgG and IgM anti-SARS-CoV-2 antibodies were analyzed. No serious UC-MSCs infusion-associated adverse events were observed. Two patients receiving UC-MSCs developed transient facial flushing and fever, and one patient developed transient hypoxia at 12 h post UC-MSCs transfusion. Mechanical ventilation was required in one patient in the treatment group compared with four in the control group. All patients recovered and were discharged. Our data show that intravenous UC-MSCs infusion in patients with moderate and severe COVID-19 is safe and well tolerated. Phase 2/3 randomized, controlled, double-blinded trials with long-term follow-up are needed to evaluate the therapeutic use of UC-MSCs to reduce deaths and improve long-term treatment outcomes in patients with serious COVID-19.

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Section: Introductionmentioning

confidence: 99%

Human umbilical cord-derived mesenchymal stem cell therapy in patients with COVID-19: a phase 1 clinical trial

Meng

Wang

et al. 2020

Sig Transduct Target Ther

253

201

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“…Myocardia displayed cell degeneration, scattered necrosis, interstitial edema, and mild in ltration of monocytes, lymphocytes, and/or neutrophils. Multiple postmortem regions showed tunica intima in ammation, thrombosis, anemic infarct [22]. We speculated that the potential pathogenesis of myocardial injury in COVID-19 may include several processes, SARS-CoV-2 may directly invade myocytes via ACE2 and cause viral myocarditis; the imbalance between supply and demand in oxygen further results in myocardial injury; and in ammatory cytokines storm.…”

Section: Discussionmentioning

confidence: 99%

“…However, given that this patient had no clinical manifestations of myocardial injury during the whole course of this disease, it could not be concluded whether myocardium was involved in SARS-CoV-2 infection yet. The latest results of autopsy of COVID-19 victims in China demonstrated the existence of RNA and viral particles of SARS-CoV-2 in heart through qRT-PCR-based virus nuclear acid detection, electron microscopy, and immunohistochemical staining [22]. Myocardia displayed cell degeneration, scattered necrosis, interstitial edema, and mild in ltration of monocytes, lymphocytes, and/or neutrophils.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of 116 hospitalized patients with COVID-19 in Wuhan, China: a single-centered, retrospective, observational study

Xiong¹,

Liu

Li³

et al. 2020

Preprint

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Background A cluster of acute respiratory illness, now known as Corona Virus Disease 2019 (COVID-19) caused by 2019 novel coronavirus (SARS-CoV-2), has become a global pandemic. Aged population with cardiovascular diseases are more likely be to infected with SARS-CoV-2 and result in more severe outcomes and elevated case-fatality rate. Meanwhile, cardiovascular diseases have a high prevalence in the middle-aged and elderly population. However, despite of several researches in COVID-19, cardiovascular implications related to it still remains largely unclear. Therefore, a specific analysis in regard to cardiovascular implications of COVID-19 patients is in great need.Methods In this single-centered, retrospective, observational study, 116 patients with laboratory-confirmed COVID-19 were enrolled, who admitted to the General Hospital of Central Theater Command (Wuhan, China) from January 20 to March 8, 2020. The demographic data, underlying comorbidities, clinical symptoms and signs, laboratory findings, chest computed tomography, treatment measures, and outcome data were collected from electronic medical records. Data were compared between non-severe and severe cases. Results Of 116 hospitalized patients with COVID-19, the median age was 58.5 years (IQR, 47.0-69.0), and 36 (31.0%) were female. Hypertension (45 [38.8%]), diabetes (19 [16.4%]), and coronary heart disease (17 [14.7%]) were the most common coexisting conditions. Common symptoms included fever [99 (85.3%)], dry cough (61 [52.6%]), fatigue (60 [51.7%]), dyspnea (52 [44.8%]), anorexia (50 [43.1%]), and chest discomfort (50 [43.1%]). Local and/or bilateral patchy shadowing were the typical radiological findings on chest computed tomography. Lymphopenia (lymphocyte count, 1.0 × 109/L [IQR, 0.7-1.3]) was observed in 66 patients (56.9%), and elevated lactate dehydrogenase (245.5 U/L [IQR, 194.3-319.8]) in 69 patients (59.5%). Hypokalemia occurred in 24 (20.7%) patients. Compared with non-severe cases, severe cases were older (64.0 years [IQR, 53.0-76.0] vs 56.0 years [IQR, 37.0-64.0]), more likely to have comorbidities (35 [63.6%] vs 24 [39.3%]), and more likely to develop acute cardiac injury (19 [34.5%] vs 4 [6.6%]), acute heart failure (18 [32.7%] vs 3 [4.9%]), and ARDS (20 [36.4%] vs 0 [0%]). During hospitalization, the prevalence of new onset hypertension was significantly higher in severe patients (55.2% vs 19.0%) than in non-severe ones.Conclusions In this single-centered, retrospective, observational study, we found that the infection of SARS-CoV-2 was more likely to occur in middle and aged population with cardiovascular comorbidities. Cardiovascular complications, including new onset hypertension and heart injury were common in severe patients with COVID-19. More detailed researches in cardiovascular involvement in COVID-19 are urgently needed to further understand the disease.

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“…However, in another recent study evaluating the semen of 38 COVID-19 patients from China, 15.8% (6/38) of the patients were positive for SARS-CoV-2 in the semen (Li et al 2020). In addition, a recent autopsy report for 91 COVID-19 victims described varying degrees of spermatogenic cell reduction and damage, and SARS-COV-2 RNA and virus particles were detected in the testes of several patients (Bian and Team 2020).…”

Section: The Potential Risk Of Reproductive Complications Caused By Cmentioning

confidence: 96%

SARS-CoV-2 and the reproductive system: assessment of risk and recommendations for infection control in reproductive departments

Bin

et al. 2020

Systems Biology in Reproductive Medicine

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The World Health Organization has declared the outbreak of the coronavirus disease COVID-19, caused by SARS-CoV-2, a pandemic. This novel infectious disease has rapidly become a global health threat. Currently, there are limited data on the extent of reproductive system damage caused by COVID-19. We reviewed the potential risks for complications in the reproductive system caused by COVID-19 infection. In addition, based on the latest American Society for Reproductive Medicine (ASRM), and European Society of Human Reproduction and Embryology (ESHRE), recommendations regarding clinical and patient management, we provide a series of suggestions for infection control measures in reproductive medicine departments. With the gradual restoration of reproductive care services, reproductive departments in epidemic areas should actively seek to minimize COVID-19 infection of both healthcare workers and patients.

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Autopsy of COVID-19 patients in China

Cited by 122 publications

References 4 publications

Human umbilical cord-derived mesenchymal stem cell therapy in patients with COVID-19: a phase 1 clinical trial

Human umbilical cord-derived mesenchymal stem cell therapy in patients with COVID-19: a phase 1 clinical trial

Clinical characteristics of 116 hospitalized patients with COVID-19 in Wuhan, China: a single-centered, retrospective, observational study

SARS-CoV-2 and the reproductive system: assessment of risk and recommendations for infection control in reproductive departments

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