Abstract
COVID-19 is an acute respiratory infection caused by SARS-CoV-2 coronavirus causing pneumonia, lesions in the cardiovascular system and other organs, high mortality risk, especially in geriatric patients. Due to the great relevance, this study was aimed at describing the case of severe COVID-19 with development of multiple organ failure. Materials and methods. Available accompanying medical documentation (outpatient charts, medical history) was analyzed. Clinical and morphological analysis was carried out by providing description of macro- and micropreparations; histological methods (hematoxylin and eosin staining, Lee reaction) were used. Results. Female patient K.G., 69 years old, was hospitalized to the therapeutic department diagnosed with coronary heart disease. Acute coronary syndrome with ST segment elevation was made on 04/20/2020. A competing diagnosis: severe community-acquired bilateral multi-segmental pneumonia. The patient’s condition was aggravated wile applying therapy followed by biological death occurred. An autopsy revealed bilateral subtotal hemorrhagic pneumonia. Macroscopic lung examination demonstrated “lungs filled with red fluid”. In the brain — perivascular and pericellular edema, hyalinosis, blood stasis and sludge, marked dystrophic and necrotic neuronal changes. Cardiomyocyte fragmentation, areas of perivascular sclerosis with inflammatory infiltrates as well as erythrocytic sludge are found in the heart and blood vessels, respectively. A weak positive reaction according to Lee method was observed. Such clinical and morphological case demonstrates along with lung damage involvement of the heart resulting in acute coronary syndrome (morphologically manifested by ischemic myocardial dystrophy) and the brain. Thus, premorbid background in elderly patients results in developing acute pulmonary heart failure, pulmonary and cerebral edema.
Highlights
COVID-19 is an acute respiratory infection caused by SARS-CoV-2 coronavirus causing pneumonia, lesions in the cardiovascular system and other organs, high mortality risk, especially in geriatric patients
Due to the great relevance, this study was aimed at describing the case of severe COVID-19 with development of multiple organ failure
Female patient K.G., 69 years old, was hospitalized to the therapeutic department diagnosed with coronary heart disease
Summary
COVID-19 — острая респираторная инфекция, вызываемая коронавирусом SARS-CoV-2, вызывающая пневмонию, поражение сердечно-сосудистой системы и других органов, с высоким риском смерти, особенно у гериартрических пациентов. Проведен клинико-морфологический анализ с помощью описания макро- и микропрепаратов, использованы гистологические методы (гематоксилином и эозином, реакция по Ли). Данный клинико-морфологический случай демонстрирует, кроме поражения легких, вовлечение в процесс сердца с развитием острого коронарного синдрома (морфологически проявляющийся ишемической дистрофией миокарда) и головного мозга. Наличие преморбидного фона у пожилых пациентов приводит к развитию острой легочно-сердечной недостаточности, отеку легких и головного мозга.
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