COVID-19: Brief check through the pathologist's eye (autopsy archive)

Mansueto, Gelsomina

doi:10.1016/j.prp.2020.153195

Cited by 31 publications

(29 citation statements)

References 26 publications

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“…Table 1 and Appendix A report the main autopsy studies during the COVID-19 pandemic. As expected, pulmonary and cardiovascular lesions were those investigated the most and basically appeared not to be different from those previously described in SARS-CoV and MERS-CoV [ 51 , 52 , 53 ]. Diffuse alveolar damage, myocarditis, myocardial infarction, thromboembolism, disseminated intravascular coagulation, among others, have been reported.…”

Section: Resultssupporting

confidence: 80%

“…To date, the management of neurological symptoms and therapy of COVID-19 patients seem to be more challenging than pulmonary and cardiovascular manifestations, those being more systematically investigated [ 48 , 49 , 50 , 51 , 52 , 53 ]. Furthermore, in the pandemic scenario, some symptoms, and signs of CNS involvement, e.g., those underlying meningitis or encephalitis, were not always correctly diagnosed and promptly managed.…”

Section: Introductionmentioning

confidence: 99%

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Neurological Sequelae in Patients with COVID-19: A Histopathological Perspective

Fisicaro

Napoli²,

Liberto

et al. 2021

IJERPH

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Background: Neuroinvasive properties of SARS-CoV-2 have allowed the hypothesis of several pathogenic mechanisms related to acute and chronic neurological sequelae. However, neuropathological correlates have been poorly systematically investigated, being retrieved from reports of single case or limited case series still. Methods: A PubMed search was carried out to review all publications on autopsy in subjects with “COronaVIrus Disease-19” (COVID-19). Among them, we focused on histological findings of the brain, which were compared with those from the authors’ autoptic studies performed in some COVID-19 patients. Results: Only seven studies reported histological evidence of brain pathology in patients deceased for COVID-19, including three with reverse transcription–quantitative polymerase chain reaction evidence of viral infection. All these studies, in line with our experience, showed vascular-related and infection-related secondary inflammatory tissue damage due to an abnormal immune response. It is still unclear, however, whether these findings are the effect of a direct viral pathology or rather reflect a non-specific consequence of cardiovascular and pulmonary disease on the brain. Conclusions: Notwithstanding the limited evidence available and the heterogeneity of the studies, we provide a preliminary description of the relationship between SARS-CoV-2 and brain sequelae. Systematic autoptic investigations are needed for accurate detection and adequate management of these patients.

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Section: Resultssupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Neurological Sequelae in Patients with COVID-19: A Histopathological Perspective

Fisicaro

Napoli²,

Liberto

et al. 2021

IJERPH

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“…Specific histomorphological changes that would allow COVID-19 diagnosis or specific SARS-CoV-2-induced viropathic morphological changes have not been reported to date [26,32,41,42]. At present, it seems unlikely that such changes could be identified.…”

Section: Morphology Of Organ Damagementioning

confidence: 93%

Detection methods for SARS-CoV-2 in tissue

Stillfried

2021

Pathologe

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Several methods are available for SARS-CoV-2 detection: electron microscopy, antigen detection by immunohistochemistry and immunofluorescence, and nucleic acid detection by in-situ hybridization and reverse transcriptase polymerase chain reaction (RT-PCR). Due to various factors in the preanalytical, analytical, and postanalytical phase, virus detection in pathology material presents specific diagnostic challenge. This article gives an overview of several SARS-CoV-2 detection methods and discusses existing data on specific sources of error, validity, and robustness of these methods.

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“…Spezifische histomorphologische Veränderungen, die eine COVID-19-Diagnose erlauben würden oder spezifische SARS-CoV-2-induzierte viropathische morphologische Phänotypen sind bislang nicht bekannt [ 26 , 32 , 41 , 42 ]. Derzeit erscheint es unwahrscheinlich, dass solche Veränderungen identifiziert werden können.…”

Section: Sars-cov-2-nachweismethodenunclassified

Nachweismethoden von SARS-CoV-2 in Gewebe

Stillfried

2021

Pathologe

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Hintergrund Die Analyse von SARS-CoV‑2 in Geweben von COVID-19-Patienten ist wichtig für ein besseres Verständnis der Pathophysiologie der Krankheit, die Interpretation der diagnostischen histopathologischen Befunde in Autopsien, Biopsien und Resektaten oder um ein potenzielles berufsbedingtes Infektionsrisiko einzuschätzen. Material und Methoden In dieser Übersichtsarbeit haben wir 136 publizierte Studien zu Detektionsmethoden von SARS-CoV‑2 in Gewebe in der kuratierten Literaturdatenbank LitCovid von PubMed identifiziert und bezüglich Fehlerquellen, Spezifität und Sensitivität der Methoden unter Berücksichtigung eigener Erfahrungen ausgewertet. Ergebnisse Es gibt keine ausreichend spezifischen histomorphologischen Veränderungen bzw. diagnostischen Merkmale von COVID-19. Daher werden 3 Ansätze zum SARS-CoV-2-Nachweis genutzt: Nachweis von RNA, Proteinen/Antigenen oder morphologischer Nachweis mittels Elektronenmikroskopie. In der präanalytischen Phase liegt die dominante Fehlerquelle in der Gewebequalität, insbesondere den unterschiedlichen Intervallen zwischen Probenentnahme und -aufarbeitung, sowie spezifisch in Autopsien im Intervall zwischen Tod und Probenentnahme. Diese Angaben finden sich in weniger als der Hälfte der Studien (z. B. nur in 42 % der Autopsiestudien). Eigene Erfahrungen und erste Studien belegen die deutlich höhere Sensitivität und Spezifität von RNA-basierten Nachweismethoden gegenüber Antigen- bzw. Proteinnachweis mittels Immunhistochemie oder Immunfluoreszenz. Der Nachweis mittels Elektronenmikroskopie ist zeitintensiv und die Interpretation schwierig. Schlussfolgerungen Es stehen verschiedene Methoden zum Nachweis von SARS-CoV‑2 im Gewebe zur Verfügung. Derzeit ist der RNA-Nachweis mittels RT-PCR die Methode der Wahl. Notwendige, umfangreiche Validationsstudien und Methodenharmonisierung sind derzeit noch nicht verfügbar. Zusatzmaterial online Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00292-021-00919-8) enthalten.

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COVID-19: Brief check through the pathologist's eye (autopsy archive)

Cited by 31 publications

References 26 publications

Neurological Sequelae in Patients with COVID-19: A Histopathological Perspective

Neurological Sequelae in Patients with COVID-19: A Histopathological Perspective

Detection methods for SARS-CoV-2 in tissue

Nachweismethoden von SARS-CoV-2 in Gewebe

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