Multiple organ damage in patients with SARS-CoV-2 infection
Keywords:
autopsy, SARS-CoV-2, systemic inflammatory responseAbstract
Introduction: Multiple organ failure is a complication of severe injuries with a systemic inflammatory response. Its morphological changes were found in patients with SARS-CoV-2 infection complicated by the action of mediators.
Objective: Characterize the presence of multiple organ damage in autopsies of patients confirmed to have SARS-CoV-2 during the different stages of circulation of the strains.
Methods: A descriptive, cross-sectional study was carried out on tissue slices of the lung, kidney, liver, heart, spleen, ileum and brain of deceased persons confirmed to have SARS‑CoV-2. They came from minimally invasive autopsies from different hospitals in the country between March 2020 and April 2022 reviewed by the special pathological anatomy working group. The circulation stages of SARS-CoV-2 strains, lung morphology, and presence of multiple organ damage were evaluated.
Results: More than a third died from permeability pulmonary edema. The frequency of damage was high. The damage score is re-evaluated according to clinical severity, with better correspondence to the evolution of these patients. The presence of an inflammatory response and loss of epithelium in the ileum was shown.
Conclusions: Multiple organ damage has a high frequency in autopsies of patients confirmed to have SARS-CoV-2. The greatest complications were observed in the circulation stages of strains β and δ. The clinical organic dysfunction incorporated into the intense scoring system of the deceased is appropriate for the expression of severity, as well as the morphology of the terminal ileum, as a criterion of immune system reactivity.
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