Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study.
Dominic Wichmann,Jan-Peter Sperhake,Marc Lütgehetmann,Stefan Steurer,Carolin Edler,Axel Heinemann,Fabian Heinrich,Herbert Mushumba,Inga Kniep,Ann Sophie Schröder,Christoph Burdelski,Geraldine de Heer,Axel Nierhaus,Daniel Frings,Susanne Pfefferle,Heinrich Becker,Hanns Bredereke-Wiedling,Andreas de Weerth,Hans-Richard Paschen,Sara Sheikhzadeh-Eggers,Axel Stang,Stefan Schmiedel,Carsten Bokemeyer,Marylyn M. Addo,Martin Aepfelbacher,Klaus Püschel,Stefan Kluge +26 more
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In this paper, the causes of COVID-19-related deaths were investigated in a single academic medical center in the German federal state of Hamburg for patients dying with a polymerase chain reaction-confirmed diagnosis of CoV-19 patients.Abstract:
Background The new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused more than 210 000 deaths worldwide However, little is known about the causes of death and the virus's pathologic features Objective To validate and compare clinical findings with data from medical autopsy, virtual autopsy, and virologic tests Design Prospective cohort study Setting Autopsies performed at a single academic medical center, as mandated by the German federal state of Hamburg for patients dying with a polymerase chain reaction-confirmed diagnosis of COVID-19 Patients The first 12 consecutive COVID-19-positive deaths Measurements Complete autopsy, including postmortem computed tomography and histopathologic and virologic analysis, was performed Clinical data and medical course were evaluated Results Median patient age was 73 years (range, 52 to 87 years), 75% of patients were male, and death occurred in the hospital (n = 10) or outpatient sector (n = 2) Coronary heart disease and asthma or chronic obstructive pulmonary disease were the most common comorbid conditions (50% and 25%, respectively) Autopsy revealed deep venous thrombosis in 7 of 12 patients (58%) in whom venous thromboembolism was not suspected before death; pulmonary embolism was the direct cause of death in 4 patients Postmortem computed tomography revealed reticular infiltration of the lungs with severe bilateral, dense consolidation, whereas histomorphologically diffuse alveolar damage was seen in 8 patients In all patients, SARS-CoV-2 RNA was detected in the lung at high concentrations; viremia in 6 of 10 and 5 of 12 patients demonstrated high viral RNA titers in the liver, kidney, or heart Limitation Limited sample size Conclusion The high incidence of thromboembolic events suggests an important role of COVID-19-induced coagulopathy Further studies are needed to investigate the molecular mechanism and overall clinical incidence of COVID-19-related death, as well as possible therapeutic interventions to reduce it Primary funding source University Medical Center Hamburg-Eppendorfread more
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Extrapulmonary manifestations of COVID-19.
Aakriti Gupta,Aakriti Gupta,Mahesh V. Madhavan,Kartik Sehgal,Kartik Sehgal,Nandini Nair,Shiwani Mahajan,Tejasav S. Sehrawat,Behnood Bikdeli,Behnood Bikdeli,Neha Ahluwalia,John C. Ausiello,Elaine Wan,Daniel E. Freedberg,Ajay J. Kirtane,Sahil A. Parikh,Mathew S. Maurer,Anna S. Nordvig,Domenico Accili,Joan M. Bathon,Sumit Mohan,Kenneth A. Bauer,Kenneth A. Bauer,Martin B. Leon,Harlan M. Krumholz,Nir Uriel,Mandeep R. Mehra,Mitchell S.V. Elkind,Mitchell S.V. Elkind,Gregg W. Stone,Allan Schwartz,David D. Ho,John P. Bilezikian,Donald W. Landry +33 more
TL;DR: The extrapulmonary organ-specific pathophysiology, presentations and management considerations for patients with COVID-19 are reviewed to aid clinicians and scientists in recognizing and monitoring the spectrum of manifestations, and in developing research priorities and therapeutic strategies for all organ systems involved.
Journal ArticleDOI
COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives.
TL;DR: The interaction between the viral spike protein and angiotensin-converting enzyme 2, which triggers entry of the virus into host cells, is likely to be involved in the cardiovascular manifestations of COVID-19.
Journal ArticleDOI
Neuropathology of patients with COVID-19 in Germany: a post-mortem case series.
Jakob Matschke,Marc Lütgehetmann,Christian Hagel,Jan Sperhake,Ann Sophie Schröder,Carolin Edler,Herbert Mushumba,Antonia Fitzek,Lena Allweiss,Maura Dandri,Matthias Dottermusch,Axel Heinemann,Susanne Pfefferle,Marius Schwabenland,Daniel Sumner Magruder,Stefan Bonn,Stefan Bonn,Marco Prinz,Christian Gerloff,Klaus Püschel,Susanne Krasemann,Martin Aepfelbacher,Markus Glatzel +22 more
TL;DR: In general, neuropathological changes in patients with COVID-19 seem to be mild, with pronounced neuroinflammatory changes in the brainstem being the most common finding, and there was no evidence for CNS damage directly caused by SARS-CoV-2.
Journal ArticleDOI
Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19.
Wentao Ni,Xiuwen Yang,Deqing Yang,Jing Bao,Ran Li,Yongjiu Xiao,Chang Hou,Haibin Wang,Jie Liu,Donghong Yang,Yu Xu,Zhaolong Cao,Zhancheng Gao +12 more
TL;DR: The SARS-CoV-2 spike glycoprotein, which binds to ACE2, is a potential target for developing specific drugs, antibodies, and vaccines and Restoring the balance between the RAS and ACE2/angiotensin-(1–7)/MAS may help attenuate organ injuries.
Journal ArticleDOI
Risk factors for severe and critically ill COVID-19 patients: A review.
Ya-dong Gao,Mei Ding,Mei Ding,Xiang Dong,Jin-jin Zhang,Ahmet Kursat Azkur,Dilek Azkur,Hui Gan,Yuan-Li Sun,Wei Fu,Wei Li,Hui-ling Liang,Yiyuan Cao,Qi Yan,Can Cao,Hong-yu Gao,Marie-Charlotte Brüggen,Willem van de Veen,Milena Sokolowska,Mübeccel Akdis,Cezmi A. Akdis +20 more
TL;DR: In this review, the scientific evidence on the risk factors of severity of COVID‐19 are highlighted and socioeconomic status, diet, lifestyle, geographical differences, ethnicity, exposed viral load, day of initiation of treatment, and quality of health care have been reported to influence individual outcomes.
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