Vision of the causes of death by COVID-19 with the experiences of autopsies
Keywords:
autopsies, SARS-CoV2, COVID-19, causes of death.Abstract
On January 30, 2020, the World Health Organization (WHO) declared SARS-CoV-2 infection an international public health emergency. The autopsy, considered the best method of studying the patient and the disease, corroborates that patients can die from the direct action of the virus (who died from COVID-19), while others positive for SARS-CoV-2 did not show morphological lung changes attributed to the action of the virus. It is proposed to establish the morphological diagnostic criteria in the context of the SARS-CoV-2 and COVID-19 epidemic in the deceased in Cuba based on the systematic study of autopsies. The morphological patterns that are established in the lungs of patients who died under the effect of COVID-19 have been identified. The pulmonary edema of permeability with the widening of the pulmonary septum, the deposit of the disorganized hyaline membrane inside the alveoli, the detachment of epithelial cells (pneumocytes and bronchial and bronchiolar cells), followed by epithelial hyperplasia with sometimes the presence of metaplastic changes and atypia, and finally, fibrosis. When autopsies are performed, it is possible to locate each disease in its place, in chronopathogram, which allows death certificates repair to be carried out to assess the place that COVID-19 has occupied as a cause of death in the population studied. In the opinion of the group, identifying morphological alterations is essential to prepare the chronopathogram of the deceased and the adequate clinical-pathological evaluation of the patient.Downloads
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3. Hurtado de Mendoza Amat J. Autopsia: Garantía de calidad en la medicina. La Habana: Editorial Ciencias Médicas; 2009. [acceso: 18/05/2020]. Disponible en: http://www.sld.cu/galerias/pdf/soporte/ftp/la_autopsia_garantia_de_calida-d_en_la_medicina.pdf
4. Hurtado de Mendoza JA, Montero TG, Ygualada YC. Situación actual y perspectiva de la autopsia en Cuba. Rev Cubana Salud Pública. 2013 [acceso: 18/05/2020]; 39(1): 135-47. Disponible en: http://www.revsaludpublica.sld.cu/index.php/spu/article/view/155/154
5. Centro Nacional de Información de Ciencias Médicas. Protocolos de actuación frente a la COVID-19. Bibliodir. 2020 [acceso: 20/07/2020]; 6(8): [aprox. 7 p.]. Disponible en: http://files.sld.cu/bmn/files/2020/08/bibliodir-agosto-2020.pdf
6. Montero González T, Hurtado de Mendoza Amat J, Fraga Martínez Y, Torres Gómez Y, Laguna Oliva L. Metodología para realizar autopsias en el proceso de enfrentamiento a la COVID-19. Rev Cubana Med Milit. 2020 [acceso: 12/10/2020]; 49(3):e0200840. Disponible en: http://www.revmedmilitar.sld.cu/index.php/mil/article/view/840
7. Montero González T, Hurtado de Mendoza Amat J, Fraga Martínez Y, Laguna Oliva L, del Rosario Cruz L, Torres Gómez Y. Experiencia en autopsias de fallecidos con la COVID-19 en el Hospital Militar Central "Dr. Luis Díaz Soto". Rev Cubana Med Milit. 2020 [acceso: 20/11/2020]; 49(4): e0200850. Disponible en: http://www.revmedmilitar.sld.cu/index.php/mil/article/view/850
8. Capó de Paz, V, Borrajero Martínez I, Montero González T, Hurtado de Mendoza Amat J, De Armas Rodríguez Y, Domínguez Alvarez C. Hallazgos de autopsias de 50 fallecidos con SARS-CoV-2 en Cuba entre abril y septiembre de 2020. Anales de la Academia de Ciencias de Cuba. 2021 [acceso: 20/11/2020]; 11(2):[aprox. 35 p.]. Disponible en: http://www.revistaccuba.cu/index.php/revacc/article/view/994
9. Socorro Castro C, Roque Roque L, Garcés Garcés B, Oliver Cruz M. Consideraciones sobre autopsia desde una perspectiva ciencia, tecnología y sociedad. Medisur. 2017 [acceso: 20/11/2020]; 15(5): 666-75. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727-897X2017000500012&lng=es
10. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID‐19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020 [acceso: 04/06/2020]; 8:420‐422. Disponible en: https://covid-19.conacyt.mx/jspui/bitstream/1000/1079/1/105281.pdf
11. Hanley B, Lucas SB, Youd E, Swift B, Osborn M. J Clin Pathol. 2020 [acceso: 15/11/2020]; 73:239-42 Disponible en: https://jcp.bmj.com/content/jclinpath/73/5/239.full.pdf
12. Solarino B, Ferorelli D, Dell'Erba A. Post-mortem routine practice in the era of the COVID-19 pandemic. Journal of Forensic and Legal Medicine. 2020; 74:102010. DOI: 10.1016/j.jflm.2020.102010
13. Caramaschi S, Kapp ME, Miller SE, Eisenberg R, Johnson J, Epperly G, et al. Histopathological findings and clinicopathologic correlation in COVID-19: a systematic review. Mod Pathol. 2021 [acceso: 12/12/2020]; 34(9):1614-33. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34031537/
14. Deshmukh V, Motwani R, Kumar A, Kumari C, Raza K. Histopathological observations in COVID-19: a systematic review. J Clin Pathol. 2021; 74:76-83. DOI: 10.1136/jclinpath-2020-206995
15. Montero González T, Hurtado de Mendoza Amat J, Iglesias Duquesne MM, Beato Canfux A, Pedroso Garriga TM, Palacios Alfonso IR. Alteraciones morfológicas en la enfermedad por quemaduras: experiencias en 156 autopsias. Rev Cub Med Mil. 2008 [acceso: 24/12/2019]; 37(3): (aprox. 12 p.) Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-65572008000300004&lng=es
16. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. International Journal of Antimicrobial Agents. 2020; 55:105924. DOI: 10.1016/j.ijantimicag.2020.105924
Published
2022-04-02
How to Cite
1.
Montero González T, Hurtado de Mendoza Amat JD, Borrajero Martínez I, Capo de Paz V, López Marin L, Fraga Martínez Y, et al. Vision of the causes of death by COVID-19 with the experiences of autopsies. Rev Cubana Med Milit [Internet]. 2022 Apr. 2 [cited 2025 Apr. 4];51(2):e02201765. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/1765
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