Pathomorphological changes of the respiratory tract in COVID-19 by autopsy data in the odesa region for 2020–2023

Abstract

The spread of COVID-19 in Ukraine was documented on March 3, 2020. The first fatal case from coronavirus infection in Odesa region was recorded on April 23, 2020. A total of 1294 patients died from complications of the coronavirus disease in Odesa and Odesa region in 2020, 5560 patients died in 2021, and a total of 917 people died from coronavirus infection in 2022. The aim of the study was to identify and study morphologic changes in the respiratory tract of patients who died from coronavirus infection in Odesa region. Materials and methods. 50 cases of those who died between 2020 and 2023 with diagnosed COVID-19 (from the total number of those who died from complications of coronavirus disease in Odesa and the region) were randomly selected. Autopsy material was examined using routine morphologic methods. Results and Discussion. Of the 7,785 people who died from complications of coronavirus disease: 3,922 cases were men (50.4 %), women – 3863(49.6 %). The largest group of the deceased that were people aged ≥ 71 years composed 3373 cases (43.3 % of the total number of those who died from complications of coronavirus disease). Of these, 1,691 were males (50.1 %) and 1,682 were females (49.8 %). Interstitial inflammatory infiltrate, cytopathic viral damage of alveolar epithelium, edema, hyaline membrane formation were found in the lung tissue of 47 deceased. The presence of multinucleated symplasts in the epithelium, desquamated atypical alveolocytes with large polymorphic nuclei, inclusions in the nuclei and cytoplasm, accumulations of erythrocytes, alveolar macrophages, marked edema, fibrin deposits were noted. Blood coagulation disorders occur due to damage to the endothelium of blood vessels, as well as liver cells, with the further development of thrombosis and hemorrhage. Hyperplasia of bronchiolar epithelium with areas of squamous cell metaplasia and dysplasia was also found. Conclusions. The average age of the dead (men and women) was 64.5 ± 7.9 years. The revealed morphological changes in the respiratory tract are a consequence of both viral and leukocytic aggression. These changes underlie further progression of the disease and development of its complications.

Дослідження зосереджено на виявленні та інтерпретації морфологічних змін у респіраторному тракті пацієнтів, які померли від коронавірусної інфекції. Аутопсійний матеріал (із загальної кількості померлих від ускладнень коронавірусної хвороби в Одесі та області за 2020–2023 рр.) досліджували за допомогою рутинних морфологічних методів. Виявлені морфологічні зміни в респіраторному тракті є наслідками як вірусної, так і лейкоцитарної агресії та лежать в основі подальшого прогресування захворювання й розвитку його ускладнень.