tetano
Editor, Senior Moderator
Int J Infect Dis
. 2021 Jun 2;S1201-9712(21)00472-0.
doi: 10.1016/j.ijid.2021.05.069. Online ahead of print.
COVID-19: Autopsy findings in six patients between 26 and 46 years of age
Selina Greuel[SUP] 1 [/SUP], Jana Ihlow[SUP] 2 [/SUP], Mihnea-Paul Dragomir[SUP] 1 [/SUP], Simon Streit[SUP] 3 [/SUP], Victor Max Corman[SUP] 4 [/SUP], Linus Haberbosch[SUP] 5 [/SUP], David Winkler[SUP] 1 [/SUP], Jenny Meinhardt[SUP] 3 [/SUP], Tom Aschman[SUP] 3 [/SUP], Julia Schneider[SUP] 4 [/SUP], Iryna Trotsyuk[SUP] 1 [/SUP], Catarina Alisa Kunze[SUP] 1 [/SUP], Lukas Maurer[SUP] 5 [/SUP], Helena Radbruch[SUP] 3 [/SUP], Frank L Heppner[SUP] 6 [/SUP], David Horst[SUP] 1 [/SUP], Sefer Elezkurtaj[SUP] 1 [/SUP]
Affiliations
Abstract
Objectives: Studies on the coronavirus disease 2019 (COVID-19) usually focus on middle aged and older adults. However, younger patients may present with severe COVID-19 and potentially fatal outcomes. For optimized, more specialized therapeutic regimens in this particular patient group, a better understanding of underlying pathomechanisms is of uttermost importance.
Methods: This study investigates relevant pre-existing medical conditions, clinical histories and autopsy findings, together with SARS-CoV-2-RNA, determined by qPCR, and laboratory data in six COVID-19 decedents at an age of 50 years or younger who were autopsied at the Charité University Hospital.
Results: From a total of 76 COVID-19 patients who underwent an autopsy at our institution, 6 (7.9%) were 50 years old or younger. Most COVID-19 decedents of younger age presented with pre-existing medical conditions prior to SARS-CoV-2 infection. These included overweight and obesity, arterial hypertension, asthma, obstructive sleep apnea as well as graft-versus-host disease following cancer and bone marrow transplantation. Furthermore, clinical histories and autopsy results revealed a disproportionally high prevalence of thromboembolism and ischemic organ damage in this patient cohort. Histopathology and laboratory results indicated coagulopathies, signs of immune dysregulation and liver damage.
Conclusions: In conclusion, pre-existing health conditions may increase the risk of severe and fatal COVID-19 in younger patients who may be especially prone to developing thromboembolic complications, immune dysregulation and liver damage.
Keywords: Autopsy; COVID-19; Cause of Death; SARS-CoV-2; Younger.
. 2021 Jun 2;S1201-9712(21)00472-0.
doi: 10.1016/j.ijid.2021.05.069. Online ahead of print.
COVID-19: Autopsy findings in six patients between 26 and 46 years of age
Selina Greuel[SUP] 1 [/SUP], Jana Ihlow[SUP] 2 [/SUP], Mihnea-Paul Dragomir[SUP] 1 [/SUP], Simon Streit[SUP] 3 [/SUP], Victor Max Corman[SUP] 4 [/SUP], Linus Haberbosch[SUP] 5 [/SUP], David Winkler[SUP] 1 [/SUP], Jenny Meinhardt[SUP] 3 [/SUP], Tom Aschman[SUP] 3 [/SUP], Julia Schneider[SUP] 4 [/SUP], Iryna Trotsyuk[SUP] 1 [/SUP], Catarina Alisa Kunze[SUP] 1 [/SUP], Lukas Maurer[SUP] 5 [/SUP], Helena Radbruch[SUP] 3 [/SUP], Frank L Heppner[SUP] 6 [/SUP], David Horst[SUP] 1 [/SUP], Sefer Elezkurtaj[SUP] 1 [/SUP]
Affiliations
- PMID: 34089883
- DOI: 10.1016/j.ijid.2021.05.069
Abstract
Objectives: Studies on the coronavirus disease 2019 (COVID-19) usually focus on middle aged and older adults. However, younger patients may present with severe COVID-19 and potentially fatal outcomes. For optimized, more specialized therapeutic regimens in this particular patient group, a better understanding of underlying pathomechanisms is of uttermost importance.
Methods: This study investigates relevant pre-existing medical conditions, clinical histories and autopsy findings, together with SARS-CoV-2-RNA, determined by qPCR, and laboratory data in six COVID-19 decedents at an age of 50 years or younger who were autopsied at the Charité University Hospital.
Results: From a total of 76 COVID-19 patients who underwent an autopsy at our institution, 6 (7.9%) were 50 years old or younger. Most COVID-19 decedents of younger age presented with pre-existing medical conditions prior to SARS-CoV-2 infection. These included overweight and obesity, arterial hypertension, asthma, obstructive sleep apnea as well as graft-versus-host disease following cancer and bone marrow transplantation. Furthermore, clinical histories and autopsy results revealed a disproportionally high prevalence of thromboembolism and ischemic organ damage in this patient cohort. Histopathology and laboratory results indicated coagulopathies, signs of immune dysregulation and liver damage.
Conclusions: In conclusion, pre-existing health conditions may increase the risk of severe and fatal COVID-19 in younger patients who may be especially prone to developing thromboembolic complications, immune dysregulation and liver damage.
Keywords: Autopsy; COVID-19; Cause of Death; SARS-CoV-2; Younger.