Autopsy results of the world's largest new crown pneumonia patient to date
Last Update: 2020-06-16
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At the end of February, Liu Liang, president of the Hubei Provincial Association for Forensic Identification and a professor of forensic pathology at Tongji Medical School of Huazhong University of Science and Technology, published the first autopsy report on the posthumous interpretation of xinguan pneumonia in the Journal of Forensic MedicineRecently, in the National Science Review, Yu Xiuwu and others published a research paper entitled "Octy of COVID-19 victims in China", a total of 91 cases of new crown pneumonia patients autopsy results summarized, of which 37 cases for systematic autopsies, 54 cases for minimally invasive autopsies, from the number of the world's largest new coronavirus pneumonia autopsy reportIn the paper, the researchers said that SARS-CoV-2 infection can cause damage to multiple organs and tissues of the human body, accompanied by obvious and widespread lung lesions, although SARS-CoV-2 infection caused by the pathological characteristics of lung lesions similar to SARS infection, but there are some differencesPreviously, in Liu Liang's team to carry out the first case of new coronal pneumonia body puncture, also found that the new coronavirus and SARS and MERS coronavirus caused by the pathological characteristics are very similar, but from the general observation of that case of anatomy, lung fibrosis and reality did not sars caused by serious lesions, and osmosis reaction is more obvious than SARSOne possible reason given at the time was that the patient had a shorter course of life only 15 days from diagnosis to deathIn this autopsy, the researchers in some patients found a strong space-time heterogeneous lesions, of which respiratory system lesions are the most significant, the patient's trachea and bronchial mucosa congestion, secretion increased, local epithelial shedding, the actual changes in the lungs showed differences in the distribution of the rangeUnder the optical microscope, the patient's physical area has diffuse alveoli damage and oozing inflammation, fibrosis oozing in the alveoli cavity and transparent membrane formation, oozing cells are mainly mononuclear and white blood cell macrophages, type II alveolar epithelial cells significantly multiply, bureau-based pulmonary cells peeling significantlyPart of the bronchial mucosal epithelial shedding, mucus protein accumulation, mucous blockage formation, a small number of alveoli over-inflated, alveostic interval rupture or cystic cavity formation, pulmonary tissue lesions bleeding, necrosis, hemorrhagic infarction, electroscopic subsydgeal epithelial and type II alcosatropic epithelial cell cytoplasm visible coronavirus particles, in a longer course of cases, also appeared pulmonary alcotosis and pulmonary fibrosisImmunohistation results showed that THE SARS-CoV-2 virus entered the receptor (i.eACE2) in some trachea and bronchial mucosal epithelial cells, etcpositive, trachea and lung tissue positive for SARS-CoV-2 nucleic acid, which is considered to be the pathological basis of fatal respiratory failure in patientsAt the same time, the researchers also found that SARS-CoV-2 infection can cause acute damage to multiple organs of the bodySignificant lesions in lymphatic hematopoietic organs; reduced CD4 plus T and CD8-T cells in the lymph nodes, hyperplorcy spleen hyperplorcys in the spleen; myocardial muscle seludes, exudative necrosis; interstitial edema, mild immersion of mononucleosis; and gallbladder height Fully charged, mucous epithelial shedding, liver cell degeneration, spot necrosis, fragmentation, bridging or a large number of necrosis osmosis, etc.; kidney performance as renal small blood, sectional hyperpluse or necrosis, nephrative glomerular cavity of the kidney glomerular cavityThe esophagus, stomach and intestinal mucosa showed varying degrees of degeneration, necrosis and sheddingPatients' testicles show varying degrees of sperm cell reduction and damageThe patient's brain observed changes in cerebral congestion, edema, and part of neuronal parallel lines and ischemic, as well as some cases of neurosopharyngeal pain, with a few cases of cerebral palsyIn addition, the researchers note in the article that in the autopsies of some elderly patients found a large number of underlying diseases, including respiratory diseases (chronic bronchitis, bronchodilatal dilation, etc.), cardiovascular disease (atherosclerosis, myocardial hypertrophy, etc.), digestive diseases (viral hepatitis and cirrhosis, chronic gastritis, stone gallbladder, etc.), urinary system diseases (renal cystics, chronic cystitis, protosm, etc.), brain damage (old brain infarction), etc Together with acute injuries caused by SARS-CoV-2 infection, these diseases contribute to the pathological basis of multi-organ dysfunction syndrome, with more serious consequences for lesions in the lungs, heart, kidneys and liver, and in autopsy cases, the main cause of death is multi-organ dysfunction syndrome, especially acute respiratory distress syndrome.
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