Abstract
Objective: We aimed to evaluate histopathologic alterations in
the lung, heart, liver, and spleen of coronavirus disease 2019
(COVID-19) decedents through postmortem core needle biopsies.
Materials and Methods: Patients who died of reverse
transcription-polymerase chain reaction-proven COVID-19 were included in
this postmortem case series. Postmortem percutaneous ultrasound-guided
biopsies using 14- and 16-gauge needles were performed in the lungs,
heart, liver, and spleen. Biopsy samples were stained with
hematoxylin-eosin and examined under a light microscope.
Clinicodemographic characteristics, chest computed tomography (CT)
images, and COVID-19-related treatments of the patients were also
collected.
Results: Seven patients were included in this study. Liver and
heart tissue samples were available from all patients, and lung and
spleen tissues were available from five and three patients,
respectively. Chest CT images predominantly revealed bibasilar
ground-glass opacities. Lung biopsies showed diffuse alveolar damage in
all biopsy specimens. Heart findings were nonspecific and largely
compatible with the underlying disease. Patchy necrosis, steatosis, and
mononuclear cellular infiltration were the main findings in the liver
biopsies. Splenic histopathological examination showed that splenic
necrosis and neutrophil infiltration were the common findings in all
patients.
Conclusion: Tissue acquisition was complete for the heart and
liver and acceptable for lungs. The amount of tissue was sufficient for
a proper histopathologic examination. The histopathological findings
were generally in accordance with previous autopsy studies. The lung
radiological findings were also correlated with the histopathologic
findings. We consider that a postmortem biopsy is a feasible alternative
for histopathological examinations in COVID-19
decedents.
Keywords: biopsy, COVID-19, heart, histopathologic, liver,
lung, postmortem, SARS-CoV-2, spleen