tetano
Editor, Senior Moderator
Am J Clin Pathol
. 2023 Mar 4;aqad001.
doi: 10.1093/ajcp/aqad001. Online ahead of print.
Postmortem Histopathologic Findings and SARS-CoV-2 Detection in Autopsy Kidneys of Patients With COVID-19: A Systematic Review and Meta-Analysis
Mahsa Mahjani[SUP] 1 2 [/SUP], Mahmoud Parvin[SUP] 3 [/SUP], Saeed Ghobadi[SUP] 4 [/SUP], Alireza Jafari[SUP] 5 [/SUP], Hassan Ahangar[SUP] 6 [/SUP], Sheida Gohari[SUP] 7 [/SUP], Sepehr Gohari[SUP] 8 2 [/SUP]
Affiliations
Abstract
Objectives: This systematic review and meta-analysis aimed to investigate the prevalence of postmortem kidney histopathologic features of patients with coronavirus disease 2019 (COVID-19) in addition to the rate of renal tropism in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Methods: We searched Web of Science, PubMed, Embase, and Scopus up to September 2022 to identify eligible studies. A random-effects model was used to estimate the pooled prevalence. Cochran Q test and Higgins I2 were used to assess evidence of heterogeneity.
Results: In total, 39 studies were included in the systematic review. The meta-analysis included 35 studies consisting of a total of 954 patients, with an average age of 67.1 years. The pooled prevalence of acute tubular injury (ATI)-related changes was the predominant finding (85% [95% confidence interval, 71%-95%]), followed by arteriosclerosis (80%), vascular congestion (66%), and glomerulosclerosis (40%). Endotheliitis (7%), fibrin microthrombi (12%), focal segmental glomerulosclerosis (1%), and calcium crystal deposits (1%) were seen in a smaller number of autopsies. The overall average rate of virus detection was 47.79% in the pooled data of 21 studies (272 samples).
Conclusions: The main finding-ATI-correlated to clinical COVID-19-associated acute kidney injury. The presence of SARS-CoV-2 in kidney samples in addition to vascular lesions in kidneys can be linked to direct kidney invasion by the virus.
Keywords: Autopsy; COVID-19; Histopathology; Meta-analysis; Postmortem; SARS-CoV-2.
. 2023 Mar 4;aqad001.
doi: 10.1093/ajcp/aqad001. Online ahead of print.
Postmortem Histopathologic Findings and SARS-CoV-2 Detection in Autopsy Kidneys of Patients With COVID-19: A Systematic Review and Meta-Analysis
Mahsa Mahjani[SUP] 1 2 [/SUP], Mahmoud Parvin[SUP] 3 [/SUP], Saeed Ghobadi[SUP] 4 [/SUP], Alireza Jafari[SUP] 5 [/SUP], Hassan Ahangar[SUP] 6 [/SUP], Sheida Gohari[SUP] 7 [/SUP], Sepehr Gohari[SUP] 8 2 [/SUP]
Affiliations
- PMID: 36869828
- DOI: 10.1093/ajcp/aqad001
Abstract
Objectives: This systematic review and meta-analysis aimed to investigate the prevalence of postmortem kidney histopathologic features of patients with coronavirus disease 2019 (COVID-19) in addition to the rate of renal tropism in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Methods: We searched Web of Science, PubMed, Embase, and Scopus up to September 2022 to identify eligible studies. A random-effects model was used to estimate the pooled prevalence. Cochran Q test and Higgins I2 were used to assess evidence of heterogeneity.
Results: In total, 39 studies were included in the systematic review. The meta-analysis included 35 studies consisting of a total of 954 patients, with an average age of 67.1 years. The pooled prevalence of acute tubular injury (ATI)-related changes was the predominant finding (85% [95% confidence interval, 71%-95%]), followed by arteriosclerosis (80%), vascular congestion (66%), and glomerulosclerosis (40%). Endotheliitis (7%), fibrin microthrombi (12%), focal segmental glomerulosclerosis (1%), and calcium crystal deposits (1%) were seen in a smaller number of autopsies. The overall average rate of virus detection was 47.79% in the pooled data of 21 studies (272 samples).
Conclusions: The main finding-ATI-correlated to clinical COVID-19-associated acute kidney injury. The presence of SARS-CoV-2 in kidney samples in addition to vascular lesions in kidneys can be linked to direct kidney invasion by the virus.
Keywords: Autopsy; COVID-19; Histopathology; Meta-analysis; Postmortem; SARS-CoV-2.
