Гистопатологическая характеристика мультиорганных поражений у пациентов с COVID-19

Abstract

The main cause of death in COVID-19 patients is acute respiratory distress syndrome (ARDS) and multi-organ failure, which is often caused by extrapulmonary dissemination and the direct damaging effect of SARS-COV-2 on the vital organs tissues. However, the nature of histopathological changes in vital organs and their significance in the thanatogenesis of COVID-19 remain insufficiently studied. Purpose of the research. To study the nature of histopathological changes in organs in COVID-19 patients, and to conduct a comparative analysis of the data obtained with the results of foreign countries’ studies with high mortality rates. Materials and methods. A pathologic study of 179 deceased COVID-19 patients was conducted. The median age of patients was 71 years. In 83.8% (150/179) of cases, COVID-19 was the main disease, and in 16.2% (29/179) of cases, it was concomitant. Results and discussion. Histopathological changes in COVID-19 were multi-organ in nature, which caused ARDS in 91.62%, cardiovascular insufficiency in 27.4%, brain edema – in 20.1%, pulmonary edema – in 3.9%, and pulmonary embolism – in 3.9% of cases. The morphological signs of ARDS in COVID-19 were: lung mass increase in 78.2% of cases, foci of pulmonary parenchyma compaction – 74.8%, discoloration of lung tissue – 60.3%, signs of congestion – 58.1%, the histological basis of which was diffuse alveolar damage. Conclusion. Old age and concomitant chronic diseases of vital organs are the main risk factors for death in COVID-19. Histological changes in organs can be the result of both direct exposure to the virus and hypoxic, metabolic, and ischemic damage.