Imperial College London
Alternate

ProfessorAndrewNicholson

Faculty of Medicine, National Heart & Lung Institute

Honorary Professor of Respiratory Pathology
 
 
 
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Contact

 

+44 (0)20 7351 8423andrew.nicholson

 
 
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Location

 

2119Sydney StreetRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Hanley:2020:10.1016/s2666-5247(20)30115-4,
author = {Hanley, B and Naresh, KN and Roufosse, C and Nicholson, AG and Weir, J and Cooke, GS and Thursz, M and Manousou, P and Corbett, R and Goldin, R and Al-Sarraj, S and Abdolrasouli, A and Swann, OC and Baillon, L and Penn, R and Barclay, WS and Viola, P and Osborn, M},
doi = {10.1016/s2666-5247(20)30115-4},
journal = {The Lancet Microbe},
pages = {e245--e253},
title = {Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study},
url = {http://dx.doi.org/10.1016/s2666-5247(20)30115-4},
volume = {1},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundSevere COVID-19 has a high mortality rate. Comprehensive pathological descriptions of COVID-19 are scarce and limited in scope. We aimed to describe the histopathological findings and viral tropism in patients who died of severe COVID-19.MethodsIn this case series, patients were considered eligible if they were older than 18 years, with premortem diagnosis of severe acute respiratory syndrome coronavirus 2 infection and COVID-19 listed clinically as the direct cause of death. Between March 1 and April 30, 2020, full post-mortem examinations were done on nine patients with confirmed COVID-19, including sampling of all major organs. A limited autopsy was done on one additional patient. Histochemical and immunohistochemical analyses were done, and histopathological findings were reported by subspecialist pathologists. Viral quantitative RT-PCR analysis was done on tissue samples from a subset of patients.FindingsThe median age at death of our cohort of ten patients was 73 years (IQR 52–79). Thrombotic features were observed in at least one major organ in all full autopsies, predominantly in the lung (eight [89%] of nine patients), heart (five [56%]), and kidney (four [44%]). Diffuse alveolar damage was the most consistent lung finding (all ten patients); however, organisation was noted in patients with a longer clinical course. We documented lymphocyte depletion (particularly CD8-positive T cells) in haematological organs and haemophagocytosis. Evidence of acute tubular injury was noted in all nine patients examined. Major unexpected findings were acute pancreatitis (two [22%] of nine patients), adrenal micro-infarction (three [33%]), pericarditis (two [22%]), disseminated mucormycosis (one [10%] of ten patients), aortic dissection (one [11%] of nine patients), and marantic endocarditis (one [11%]). Viral genomes were detected outside of the respiratory tract in four of five patients. The presence of subgenomic viral RNA transcripts provided evidence of
AU  - Hanley,B
AU  - Naresh,KN
AU  - Roufosse,C
AU  - Nicholson,AG
AU  - Weir,J
AU  - Cooke,GS
AU  - Thursz,M
AU  - Manousou,P
AU  - Corbett,R
AU  - Goldin,R
AU  - Al-Sarraj,S
AU  - Abdolrasouli,A
AU  - Swann,OC
AU  - Baillon,L
AU  - Penn,R
AU  - Barclay,WS
AU  - Viola,P
AU  - Osborn,M
DO  - 10.1016/s2666-5247(20)30115-4
EP  - 253
PY  - 2020///
SN  - 2666-5247
SP  - 245
TI  - Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study
T2  - The Lancet Microbe
UR  - http://dx.doi.org/10.1016/s2666-5247(20)30115-4
UR  - https://www.sciencedirect.com/science/article/pii/S2666524720301154?via%3Dihub
UR  - http://hdl.handle.net/10044/1/81956
VL  - 1
ER  -
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