Post-mortem findings in Spanish patients with COVID-19; a special focus on superinfections

Ruiz Cáceres, InmaculadaRubio García, RafaelRivero, Antonio2024-07-022024-07-022013-07-04Ruiz-Cáceres I, Hermida Romero T, Guerra Merino I, Portu Zapirain J, Pérez- Mies B, Sánchez-Conde M, Riaño MA, Rubio R, Fortés Alen J, Vidal González Á, Salas Antón C, Múñez E, Sánchez Sánchez R, Corona-Mata D, Aldecoa Ansorregui I, Miró JM, Beloqui Pérez de Obanos R, Ibero C, Gómez-Román J, Fariñas MC, Tabuyo Bello T, de Alava E, Cisneros JM, Matías-Guiu X, Rivero A; NECROCOVID Study Group. Post-mortem findings in Spanish patients with COVID-19; a special focus on superinfections. Front Med (Lausanne). 2023 Jul 4;10:115184310.3389/fmed.2023.1151843https://hdl.handle.net/20.500.14352/105419Introduction: Whole-body autopsies may be crucial to understand coronavirus disease 2019 (COVID-19) pathophysiology. We aimed to analyze pathological findings in a large series of full-body autopsies, with a special focus on superinfections. Methods: This was a prospective multicenter study that included 70 COVID-19 autopsies performed between April 2020 and February 2021. Epidemiological, clinical and pathological information was collected using a standardized case report form. Results: Median (IQR) age was 70 (range 63.75-74.25) years and 76% of cases were males. Most patients (90%,) had at least one comorbidity prior to COVID-19 diagnosis, with vascular risk factors being the most frequent. Infectious complications were developed by 65.71% of the patients during their follow-up. Mechanical ventilation was required in most patients (75.71%) and was mainly invasive. In multivariate analyses, length of hospital stay and invasive mechanical ventilation were significantly associated with infections (p = 0.036 and p = 0.013, respectively). Necropsy findings revealed diffuse alveolar damage in the lungs, left ventricular hypertrophy in the heart, liver steatosis and pre-infection arteriosclerosis in the heart and kidneys. Conclusion: Our study confirms the main necropsy histopathological findings attributed to COVID-19 in a large patient series, while underlining the importance of both comorbid conditions and superinfections in the pathology.engAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/Post-mortem findings in Spanish patients with COVID-19; a special focus on superinfectionsjournal articlehttps://doi.org/10.3389/FMED.2023.1151843open access616.24COVID-19AutopsiesInfectionPathological findingsSuperinfectionEnfermedades infecciosas3205.05 Enfermedades Infecciosas