新冠肺炎恢复期患者部分器官组织病理形态学改变

V. Akimkin, O. Levin, A. Ploskireva, A. Gorelov, A. Komarova, A. Litvinenko, N. Krivosheeva, I. O. Tinkova
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引用次数: 0

摘要

新型冠状病毒感染(COVID-19)是由SARS-CoV-2引起的高传染性病毒性疾病,导致大流行。COVID-19患者的尸检往往显示既往脑疾病的特征,包括神经退行性变、既往中风、脱髓鞘疾病和动脉粥样硬化。急性脑血管意外合并重症COVID-19患者的死亡率高于未发生脑血管意外的非重症感染患者。比较分析在不同临床首发症状时期死亡的患者肺部形态学变化。目标。病故患者恢复期病理形态学变化的描述。患者和方法。对博特金医院近2 ~ 4个月确诊为缺血性脑卒中合并新型冠状病毒感染的15例死亡病例进行分析。对脑、肺、头臂动脉、肾、肝进行了宏观和显微镜检查。结果。所有患者均具有脑灰质缺血性损伤的形态学特征。除了灰质弥漫性浸润的神经细胞坏死外,还可见苏木精循环,部分苏木精循环位于脉络膜丛血管周围。5例患者心肌梗死时间长达3天。10例患者肺实质结构紊乱,肺组织因纤维化而改变。部分肺泡多与单气道清除配合。大多数患者肺部含铁血黄素沉着可以证明冠状病毒感染早期发生微循环床损伤。结论。因此,在COVID-19恢复期所见的形态变化是先前描述的冠状病毒感染急性期变化的病理形态变化的结果,不仅影响肺部,还影响其他器官和组织。这证明了感染的系统性特征。关键词:COVID-19,急性脑血管意外,脑卒中,脑病理形态学改变
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Pathomorphological changes in some organs and tissues of COVID-19 convalescent patients
New coronavirus infection (COVID-19) is highly contagious viral disease caused by SARS-CoV-2 leading to the pandemic. The autopsy of COVID-19 patients often showed features of previous brain diseases including neurodegeneration, previous strokes, demyelinating diseases and atherosclerosis. Patients with acute cerebrovascular accidents and severe COVID-19 had higher numbers of lethality in comparison to non-severe course of infection without cerebrovascular accidents. A comparative analysis of morphological changes in lungs of deceased patients who died in different periods of first clinical symptoms is to be conducted. Objective. Description of pathomorphological changes in deceased patients during the period of reconvalescence. Patients and methods. The analysis of 15 fatal cases which took place in Botkin Hospital with the diagnosis of ischemic stroke and new coronavirus infection in the previous 2-4 months has been held. Macro and microscope examination of brain, lungs, brachiocephalic arteries, kidneys and liver has been carried out. Results. All patients had morphological features of ischemic damage of grey matter in the brain. Beside necrosis of neurocytes with diffuse infiltration in the grey matter, hematoxylin cycles were found, in some cases they were placed in a perivascular way in choroid plexus. Also 5 patients suffered a myocardial infarction up to 3 days. 10 patients had structures disorganisation in areas of lung parenchyma with hystoacrchitectonic changes because of the fibrosis. Alveoli in some places collaborated mostly with single airway clearance. The fact that most patients had lung hemosiderosis can prove coronavirus infection suffered earlier with microcirculatory bed damage. Conclusion. Thus, morphological changes seen in the period of reconvalescence of COVID-19 is a result of pathomorphosis of changes described earlier for acute period of coronavirus infection and affect not only lungs, but also other organs and tissues. This proves systematic characteristic of the infection. Key words: COVID-19, acute cerebrovascular accidents, stroke, pathomorphological changes in the brain
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来源期刊
Infektsionnye Bolezni
Infektsionnye Bolezni Medicine-Infectious Diseases
CiteScore
1.30
自引率
0.00%
发文量
15
期刊介绍: The journal publishes original research works, reviews of literature, lectures, methodological recommendations, clinical observations. Main topics: problems of etiology, pathogenesis, clinical manifestations of infectious diseases, new techniques and methods of their diagnosis, prevention and treatment; special attention is paid to the problems of antibacterial and antiviral therapy, the use of immunoglobulins and interferons, and also to intensive therapy of critical states. The journal is in the List of leading scientific journals and periodicals of the Supreme Attestation Committee, where the principal results of doctoral dissertations should be published.
期刊最新文献
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