Jonigk, Danny and Werlein, Christopher and Acker, Till and Aepfelbacher, Martin and Amann, Kerstin U. and Baretton, Gustavo and Barth, Peter and Bohle, Rainer M. and Buettner, Andreas and Buettner, Reinhard and Dettmeyer, Reinhard and Eichhorn, Philip and Elezkurtaj, Sefer and Esposito, Irene and Evert, Katja and Evert, Matthias and Fend, Falko and Gassler, Nikolaus and Gattenloehner, Stefan and Glatzel, Markus and Goebel, Heike and Gradhand, Elise and Hansen, Torsten and Hartmann, Arndt and Heinemann, Axel and Heppner, Frank L. and Hilsenbeck, Julia and Horst, David and Kamp, Jan C. and Mall, Gita and Maerkl, Bruno and Ondruschka, Benjamin and Pablik, Jessica and Pfefferle, Susanne and Quaas, Alexander and Radbruch, Helena and Roecken, Christoph and Rosenwald, Andreas and Roth, Wilfried and Rudelius, Martina and Schirmacher, Peter and Slotta-Huspenina, Julia and Smith, Kevin and Sommer, Linna and Stock, Konrad and Stroebel, Philipp and Strobl, Stephanie and Titze, Ulf and Weirich, Gregor and Weis, Joachim and Werner, Martin and Wickenhauser, Claudia and Wiech, Thorsten and Wild, Peter and Welte, Tobias and von Stillfried, Saskia and Boor, Peter (2022) Organ manifestations of COVID-19: what have we learned so far (not only) from autopsies? VIRCHOWS ARCHIV, 481 (2). pp. 139-159. ISSN 0945-6317, 1432-2307
Full text not available from this repository. (Request a copy)Abstract
The use of autopsies in medicine has been declining. The COVID-19 pandemic has documented and rejuvenated the importance of autopsies as a tool of modern medicine. In this review, we discuss the various autopsy techniques, the applicability of modern analytical methods to understand the pathophysiology of COVID-19, the major pathological organ findings, limitations or current studies, and open questions. This article summarizes published literature and the consented experience of the nationwide network of clinical, neuro-, and forensic pathologists from 27 German autopsy centers with more than 1200 COVID-19 autopsies. The autopsy tissues revealed that SARS-CoV-2 can be found in virtually all human organs and tissues, and the majority of cells. Autopsies have revealed the organ and tissue tropism of SARS-CoV-2, and the morphological features of COVID-19. This is characterized by diffuse alveolar damage, combined with angiocentric disease, which in turn is characterized by endothelial dysfunction, vascular inflammation, (micro-) thrombosis, vasoconstriction, and intussusceptive angiogenesis. These findings explained the increased pulmonary resistance in COVID-19 and supported the recommendations for antithrombotic treatment in COVID-19. In contrast, in extra-respiratory organs, pathological changes are often nonspecific and unclear to which extent these changes are due to direct infection vs. indirect/secondary mechanisms of organ injury, or a combination thereof. Ongoing research using autopsies aims at answering questions on disease mechanisms, e.g., focusing on variants of concern, and future challenges, such as post-COVID conditions. Autopsies are an invaluable tool in medicine and national and international interdisciplinary collaborative autopsy-based research initiatives are essential.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SARS-COV-2; CELLS; MYOCARDITIS; NEUROPATHOLOGY; CORONAVIRUS; INFECTION; PATHOLOGY; COHORT; GROWTH; INJURY; SARS-CoV-2; Diffuse alveolar damage; Acute kidney damage; Immune response |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Pathologie |
| Depositing User: | Petra Gürster |
| Date Deposited: | 05 Sep 2023 10:44 |
| Last Modified: | 05 Sep 2023 10:44 |
| URI: | https://pred.uni-regensburg.de/id/eprint/58799 |
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