Histopathological autopsy findings in lungs of pregnant and postpartum women who died of COVID-19 infections.

Abstract

The coronavirus disease 2019 outbreak (COVID-19) caused by the SARS-CoV coronavirus, has been declared as apandemic by the World Health Organization on 11March 2020, as aresult of which about 315,000,000 people all over the world have been infected and more than 5,000,000 died. Many scientific articles have been published concerning histopathological changes in different organs, but data concerning the lung changes of pregnant and postpartum period women who died of COVID-19 infections are still scarce. The aim of our study was to review and summarize autopsy findings and histopathological changes in lungs of pregnant and postpartum period women who died of COVID-19 infections in Armenia during 2020-2021. Lung tissue specimens of 14pregnant and postpartum period women who died of COVID-19 infections and its complications were examined. Hematoxylin-eosin and van Gieson staining methods as well as immunohistochemical examinations were used. The average age of the dead women was33.9 years. From 14cases in 9there were comorbidities. All cases of death were in the 2ndand 3rdtrimester of pregnancy or early and late postpartum period. Forensic medical diagnosis included COVID-19 infection with bilateral polysegmented pneumonia and acute respiratory failure. Histopathological examination revealed diffuse alveolar damage of lungs (DAD) in predominantly proliferation/organizing stage. Histopathological examination of lungs showed proliferative stage of DAD with signs of fibrosing pneumonia. Early diagnosis and hospitalization of pregnant women may prevent late complications of COVID-19 infection and fibrosing pneumonia development, as well as future risks of fatal outcomes in pregnant and early postpartum period.