2. Systematic pathology of other organs
COVID-19 is a systematic disease, in which multiple organs, including the lungs, heart, liver, kidney, gastrointestinal tract, the central nervous system (CNS) would be affected12, 13. Full autopsy of the present case revealed varieties of findings in other organs, but it was uncertain if they are directly associated with COVID-19, since bacterial and fungus co-infection was also observed. Additional pathological findings are described as follows.
Stomach: Severe hemorrhage with multiple ulcers. Candida infection was detected.
Heart: Diffuse neutrophil infiltration in the myocardium and stromal edema. Mural thrombus in the left auricular appendage.
Spleen: Acute splenitis with prominent neutrophil infiltration.
Kidney: Multiple abscess formation with bacterial colonies. Microcoagulopathy in glomerular blood vessels, resembling disseminated intravascular coagulation (DIC).
Lymph nodes: Lymph adenitis and erythrophagocytosis.
Prostate: Microabscess.
Liver: Mild lymphocytic infiltration in the portal area
Again, hemorrhage was severe in the right lung, as well as stomach. The clinical data of PT-INR, APTT, PT, D-dimer and platelet was reviewed, but the cause of severe hemorrhage still remained uncertain (Figure 6).