Clinico-pathological features in fatal COVID-19 infection: a preliminary experience of a tertiary care center in North India using postmortem minimally invasive tissue sampling

Goel, Ayush; Jain, Deepali; Goel, Apratim; Agarwal, Shubham; Swaroop, Shekhar; Das, Prasenjit; Arava, Sudheer; Mridha, Asit Ranjan; Nambirajan, Aruna; Singh, Geetika; Arulselvi, S; Mathur, Purva; Kumar, Sanchit; Sahni, Shweta; Nehra, Jagbir; Bm, Mouna; Rastogi, Neha; Mahato, Sandeep; Gupta, Chaavi; Bharadhan, S; Dhital, Gaurav; Goel, Pawan Kumar; Pandey, Praful; Kn, Santosh; Chaudhary, Shitij; Keri, Vishakh C; Chauhan, Vishal Singh; Mahishi, Niranjan; Shahi, Anand; Ragu, R; Gupta, Brijnandan; Aggarwal, Richa; Soni, Kapil Dev; Nischal, Neeraj; Soneja, Manish; Lalwani, Sanjeev; Sarkar, Chitra; Guleria, Randeep; Wig, Naveet; Trikha, Anjan

doi:10.1080/17476348.2021.1951708

Cited by 6 publications

(8 citation statements)

References 37 publications

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“…We curated papers with immunohistochemical datasets and testing of different antibodies. 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 We found that the majority of studies neither validated the antibodies nor reported adequate positive and negative controls. Detection of SARS-CoV-2 proteins by IHC in autopsy tissues showed differences regarding protein amounts and interpretation of data.…”

Section: Resultsmentioning

confidence: 78%

Assessing and improving the validity of COVID-19 autopsy studies - A multicentre approach to establish essential standards for immunohistochemical and ultrastructural analyses

et al. 2022

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Section: Resultsmentioning

confidence: 78%

Assessing and improving the validity of COVID-19 autopsy studies - A multicentre approach to establish essential standards for immunohistochemical and ultrastructural analyses

et al. 2022

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“…We had previously reported the postmortem histopathological features in a small subset of the patients and the present study includes the complete series. 18 …”

Section: Methodsmentioning

confidence: 99%

A study on the morbid histopathological changes in COVID‐19 patients with or without comorbidities using minimally invasive tissue sampling

Goel

Chavan

et al. 2022

Journal of Medical Virology

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COVID‐19 causes morbid pathological changes in different organs including lungs, kidneys, liver, and so on, especially in those who succumb. Though clinical outcomes in those with comorbidities are known to be different from those without—not much is known about the differences at the histopathological level. To compare the morbid histopathological changes in COVID‐19 patients between those who were immunocompromised (Gr 1), had a malignancy (Gr 2), or had cardiometabolic conditions (hypertension, diabetes, or coronary artery disease) (Gr 3), postmortem tissue sampling (minimally invasive tissue sampling [MITS]) was done from the lungs, kidney, heart, and liver using a biopsy gun within 2 hours of death. Routine (hematoxylin and eosin) and special staining (acid fast bacilli, silver methanamine, periodic acid schiff) was done besides immunohistochemistry. A total of 100 patients underwent MITS and data of 92 patients were included (immunocompromised: 27, malignancy: 18, cardiometabolic conditions: 71). In lung histopathology, capillary congestion was more in those with malignancy, while others like diffuse alveolar damage, microthrombi, pneumocyte hyperplasia, and so on, were equally distributed. In liver histopathology, architectural distortion was significantly different in immunocompromised; while steatosis, portal inflammation, Kupffer cell hypertrophy, and confluent necrosis were equally distributed. There was a trend towards higher acute tubular injury in those with cardiometabolic conditions as compared to the other groups. No significant histopathological difference in the heart was discerned. Certain histopathological features were markedly different in different groups (Gr 1, 2, and 3) of COVID‐19 patients with fatal outcomes.

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“… 8 The incidence of vascular microthrombi has also varied from 21 to 100% across studies. 9 – 12 This variable finding needs further evaluation. The cause of mortality also depends on the local epidemiology, and the management of COVID-19 disease keeps evolving with time.…”

Section: Introductionmentioning

confidence: 93%

Pathological Lung Patterns of COVID-19 and its Clinical Correlation to Disease Severity

Rao¹,

Deepa²,

Noronha³

2022

Indian Journal of Critical Care Medicine

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A bstract Introduction Coronavirus disease-2019 (COVID-19) infection can result in pulmonary complications ranging from mild illness to severe life-threatening disease. There are limited studies correlating the association between the clinical course of COVID-19 and histopathological findings. This study aimed to examine the postmortem histopathological changes in lung tissue of COVID-19-positive patients and to correlate those changes with disease severity. Materials and methods This prospective observational study was conducted in adult COVID-19-positive patients. Postmortem core needle biopsy (CNB) of the lung was done using ultrasonography guidance within 1 hour of death. Histopathological analyses were performed by two expert pulmonary pathologists. The demographic and clinical data of the patients were recorded to correlate them with histopathological findings. Results In total, 48 patients were assessed for inclusion, and 21 patient relatives consented for the study. The median duration of illness was 21 (range 9–38) days, the predominant histopathological finding was diffuse alveolar damage (DAD) in most patients (19/21), followed by pneumonia (13/21). Exudative, intermediate, and advanced DAD patterns were seen in 9.5%, 52.4%, and 28.6% of cases, respectively. Advanced DAD was associated with a longer duration of disease. The pneumonia findings were associated with positive respiratory and blood cultures. The microvascular thrombus was seen only in one patient. Conclusion The predominant pathological findings in our patients were DAD and pneumonia. The DAD type correlated with the duration of illness, and we attributed pneumonia findings to secondary infection. The incidence of microvascular thrombi was low, and it might reflect the effect of treatment with anticoagulation. How to cite this article Maddani SS, Rao R, Deepa HC, Noronha AK, Chaudhuri S, Vishwas P. Pathological Lung Patterns of COVID-19 and its Clinical Correlation to Disease Severity. Indian J Crit Care Med 2022;26(12):1285–1292.

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Clinico-pathological features in fatal COVID-19 infection: a preliminary experience of a tertiary care center in North India using postmortem minimally invasive tissue sampling

Cited by 6 publications

References 37 publications

Assessing and improving the validity of COVID-19 autopsy studies - A multicentre approach to establish essential standards for immunohistochemical and ultrastructural analyses

Assessing and improving the validity of COVID-19 autopsy studies - A multicentre approach to establish essential standards for immunohistochemical and ultrastructural analyses

A study on the morbid histopathological changes in COVID‐19 patients with or without comorbidities using minimally invasive tissue sampling

Pathological Lung Patterns of COVID-19 and its Clinical Correlation to Disease Severity

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