In early 2020, SARS-CoV-2 caused a major pandemic with a high number of deaths worldwide and led to an overload of health systems in many countries. Despite rapid advances in understanding COVID-19, the disease caused by SARS-CoV-2, knowledge gaps remain regarding tissue lesions and mechanisms of worsening in COVID-19. This study aims to describe histological lung changes in fatal COVID-19 cases in the state of Bahia. Sixteen COVID-19 cases hospitalized in a tertiary hospital in Salvador-BA that had a fatal outcome underwent minimally invasive ultrasound-guided autopsy (AMIGUS). AMIGUS procedures were performed 6 to 10 hours after death. Tissue fragments from major organs were collected using coaxial and Tru-Cut needles. Lung fragments from four quadrants (upper lateral-QSL and medial-QSM; lower lateral-QIL and medial-QIM) of the right and left lungs were collected, fixed in 4% paraformaldehyde, routinely processed, and stained with H (b) capillary congestion (93.7%); (c) type II pneumocyte hyperplasia and hypertrophy (93.7%); and (d) hyaline membrane formation (75%). These findings were focal in >60% of cases. Diffuse alveolar damage was detected in all cases: 62.5% in the proliferative phase, 37.5% in the exudative phase, and none in the fibrotic phase. Based on histopathological evaluation of lung tissue from fatal cases, a set of tissue alterations related to disease progression and fatal outcome in COVID-19 was described.
Silva et al. (Sun,) studied this question.
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