To Evaluate The Histomorphological Changes Of Postmortem Transthoracic Needle Biopsy/Autopsy Lung In COVID-19 Patients

Authors

  • Siddiq M Ahmed Professor and HOD, Department of Pathology Shri Atal Bihari Vajpayee Medical College & Research Institute.
  • Roopa AN Associate Professor Department of Pathology Shri Atal Bihari Vajpayee Medical College & Research Institute.
  • Dileep Kumar Assistant Professor, Department of Forensic Medicine Shri Atal Bihari Vajpayee Medical College & Research Institute.
  • Kavya J Assistant professor, Department of Pathology Shri Atal Bihari Vajpayee Medical College and Research Institute, Bengaluru.

DOI:

https://doi.org/10.37506/6wtgvw34

Keywords:

COVID-19, transthoracic needle biopsy, diffuse alveolar damage, viral cytopathic changes.

Abstract

Objective: To study the histomorphological changes in postmortem needle biopsy/autopsy lung in COVID-19 Patients.

Study Design: This was an observational study done at Shri Atal Bihari Vajpayee Medical College & Research Institute, Bengaluru, and Karnataka from March 2021 to May 2021.

Methodology: A total of 30 patients who died of Covid-19 were included and all of them were diagnosed to be Covid -19 positive by RT-PCR testing. Post-mortem transthoracic needle biopsy was done to obtain lung tissue by using B-Bard biopsy gun in midaxillary approach. The biopsy samples were grossed and processed after fixing for 48hrs. The slides obtained were stained by routine hematoxylin and eosin stain, studied for morphology of the lung tissue and findings were recorded.

Results: We obtained consent for post-mortem transthoracic needle biopsy/autopsy of lung in 30 deceased cases. All these cases were positive for SARS –COV2 on RT-PCR. The age of the cases was ranging from 26-72 years and median age is 53years, males (63.3%) were affected more than females (36.7%). Most deceased had comorbidities, among them diabetes mellitus (26.6%) and hypertension (26.6%) were most common.

Lung biopsy samples were taken from 30 deceased patients. Histomorphological feature of diffuse alveolar damage was seen in 90% (27 out of 30) cases. Other findings noted on microscopy were chronic interstitial inflammation in 6.7% cases, pulmonary edema (3.33%), intra alveolar haemorrhage (3.33%) and viral cytopathic changes (3.33%).

 Conclusion This study highlighted the pulmonary morphological changes which are most prominent in COVID-19 infections, but it was a difficult to ascertain that the findings are related to viral infection or due to associated coomorbidities

References

REFERENCES:

Ray A, Jain D, Goel A, Agarwal S, Swaroop S, Das P et al. Clinico-pathological features in fatal COVID-19 infection: a preliminary experience of a tertiary care center in North India using postmortem minimally invasive tissue sampling. Expert Rev Respir Med. 2021 Oct;15(10):1367- 1375.

Xu X, Yu C, Qu J, Zhang L, Jiang S, Huang D. Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2. Eur J Nucl Med Mol Imaging. 2020 Feb 28 : 1–6.

Elsoukkary S.S.• Mostyka M. Dillard A. Berman D.R. Ma L.X. Chadburn A.: Autopsy Findings in 32 Patients with COVID-19: A Single-Institution Experience. Pathobiology 2021;88:56-68.

Bhandari S, Solanki R, Jindal A, Rankawat G, Pathak D, Bagarhatta M, et al. Demystifying COVID-19 lung pathology: A clinicopathological study of postmortem core needle biopsy. Lung India 2021;38:343-9.

Carsana L, Sonzogni A, Nasr A, Rossi RS, Pellegrinelli A, Zerbi P, et al. Pulmonary post-mortem findings in a series of COVID-19 cases from northern Italy: a two-centre descriptive study. Lancet Infect Dis. 2020;20(10):1135–40.

Tian S, Xiong Y, Liu H, Niu L, Guo J, Liao M, et al. Pathological study of the 2019 novel coronavirus disease (COVID-19) through postmortem core biopsies. Mod Pathol Off J U S Can Acad Pathol Inc. 2020;33(6):1007–14.

Brook OR, Piper KG, Mercado NB, Gebre MS, Barouch DH, Busman-Sahay K, et al. Feasibility and safety of ultrasound-guided minimally invasive autopsy in COVID-19 patients. Abdom Radiol N Y. 2020 Sep 17;1–9

Maixenchs M, Anselmo R, Zielinski-Gutiérrez E, Odhiambo FO, Akello C, Ondire M, et al. Willingness to Know the Cause of Death and Hypothetical Acceptability of the Minimally Invasive Autopsy in Six Diverse African and Asian Settings: A Mixed Methods SocioBehavioural Study. PLoS Med [Internet]. 2016 Nov 22 [cited 2020 Oct 26];13(11).

Deshmukh V, Motwani R, Kumar A, Kumari C, Raza K. Histopathological observations in COVID-19: a systematic review. J Clin Pathol. 2021 Feb;74(2):76-83.

Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med. 2020;383(2):120–8. 10.

Li Y, Wu J, Wang S, Li X, Zhou J, Huang B et al. Progression to fibrosing diffuse alveolar damage in a series of 30 minimally invasive autopsies with COVID-19 pneumonia in Wuhan, China. Histopathology. 2021 Mar;78(4):542-555.

Matthay MA, Zemans RL. The acute respiratory distress syndrome: pathogenesis and treatment. Annu Rev Pathol. 2011;6:147-63.

Polak SB, Van Gool IC, Cohen D, von der Thüsen JH, van Paassen J. A systematic review of pathological findings in COVID-19: a pathophysiological timeline and possible mechanisms of disease progression. Mod Pathol. 2020 Nov;33(11):2128-2138.

UpdatedClinicalManagementProtocolforCOVID19dated03072020.pdf [Internet]. [cited 2020 Nov 7]. Available from: https://www.mohfw.gov.in/pdf/UpdatedClinicalManagementProtocolforCOVID19dated0307202 0.pdf

Badwe RA, Dikshit R, Chaturvedi P, Gupta S. Geographical & seasonal variation in COVID-19 related mortality. Indian J Med Res. 2020 Jan 1;152(1):6.

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Published

2024-10-09

How to Cite

To Evaluate The Histomorphological Changes Of Postmortem Transthoracic Needle Biopsy/Autopsy Lung In COVID-19 Patients. (2024). Indian Journal of Forensic Medicine & Toxicology, 18(4), 141-148. https://doi.org/10.37506/6wtgvw34