ASSESSMENT OF CAUSE OF DEATH AND INTERNAL ORGANS OF HUMAN BODIES OF COVID-19 PATIENTS RECEIVED FOR AUTOPSIES TO A TERTIARY CARE HOSPITAL OF LAHORE.
DOI:
https://doi.org/10.59058/jaimc.v20i4.57Keywords:
Coronavirus disease, liver, lungs, cardiovascular diseases, cerebrovascular changesAbstract
Background and Objective: COVID-19 cause extensive effects on virtually all organs. It causes inflammation, endothelitis, vasoconstriction, hypercoagulability, and edema. Different organs may be affected at different times. Hence we aim to determine the cause of death and pattern of the injuries to the internal organs among the dead bodies of patients diagnosed with coronavirus disease.
Methods: This Cross-sectional study was conducted in the Department of Forensic Medicine, Allama Iqbal Medical College, Lahore over a 1-year period from 2021 to 2022. 150 autopsies of COVID-19-positive patients who died from Covid, during the peak era were received. Autopsies were performed and internal organs were carefully examined clinically along with histopathological evidence. Reports were assessed and the presence or absence of single or multiple organ dysfunction was recorded. The data was recorded in a proforma and entered and analyzed in SPSS version 25.
Results: The mean age of dead bodies at the time of death was 54.5 ± 14.73 years. 112 (74.7%) of these patients were males while 38 (25.3%) were females. The mean duration of COVID-19 was 14.22 ± 9.41 days and the mean duration of death until the presentation of the body for autopsy was 21.89 ± 6.37 hours. Out of 150 cases, death due to respiratory failure was observed in 67 (44.7%) cases, renal failure in 21 (14.0%) cases, liver failure in 18 (12.0%) cases, Venous thromboembolism in 16 (10.7%) cases, meningitis in 10 (6.7%) cases, intestinal perforation was observed in 9 (6.0%) cases, in 5 (3.3%) cases, peritonitis was observed and cardiac failure in 5 (3.3%) cases.
Conclusion: There are higher chances of organ failure in patients suffering from COVID-19, as proven by autopsies of COVID-19 cases.
References
Green SJ. Covid-19 accelerates endothelial dysfunction and nitric oxide deficiency. Microbes and Infection. 2020;22(4):149.
Jain U. Effect of COVID-19 on the Organs. Cureus. 2020;12(8).
Meredith Wadman JC-F, Jocelyn Kaiser CM. How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes. Science. 2020.
Lau FH, Majumder R, Torabi R, Saeg F, Hoffman R, Cirillo JD, et al. Vitamin D insufficiency is prevalent in severe COVID-19. MedRxiv. 2020.
Merad M, Martin JC. Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages. Nature Reviews Immunology. 2020;20(6):355-62.
Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, et al. Endothelial cell infection and endotheliitis in COVID-19. The Lancet. 2020;395(10234):1417-8.
Haberman R, Axelrad J, Chen A, Castillo R, Yan D, Izmirly P, et al. Covid-19 in Immune-Mediated Inflammatory Diseases — Case Series from New York. New England Journal of Medicine. 2020;383(1):85-8.
Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin E, et al. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2020;75(23):2950-73.
Dennis A, Wamil M, Kapur S, Alberts J, Badley AD, Decker GA, et al. Multi-organ impairment in low-risk individuals with long COVID. medrxiv. 2020.
Iacobucci G. Long covid: Damage to multiple organs presents in young, low risk patients. BMJ. 2020;371:m4470.
Das S, Roy A, Das R. New autopsy technique in COVID-19 positive dead bodies: opening the thoracic cavity with an outlook to reduce aerosol spread. Journal of clinical pathology. 2022.
Bhat V, Joshi A, Sarode R, Chavan P. Cytomegalovirus infection in the bone marrow transplant patient. World journal of transplantation. 2015;5(4):287-91.
Hirschbühl K, Dintner S, Beer M, Wylezich C, Schlegel J, Delbridge C, et al. Viral mapping in COVID-19 deceased in the Augsburg autopsy series of the first wave: A multiorgan and multimethodological approach. PLOS ONE. 2021;16(7):e0254872.
Faust JS, Del Rio C. Assessment of deaths from COVID-19 and from seasonal influenza. JAMA internal medicine. 2020;180(8):1045-6.
Stojanovic J, Boucher VG, Boyle J, Enticott J, Lavoie KL, Bacon SL. COVID-19 is not the flu: four graphs from four countries. Frontiers in Public Health. 2021;9:628479.
Reiner Benaim A, Sobel JA, Almog R, Lugassy S, Ben Shabbat T, Johnson A, et al. Comparing COVID-19 and influenza presentation and trajectory. Frontiers in Medicine. 2021:634.
Waidhauser J, Martin B, Trepel M, Märkl B. Can low autopsy rates be increased? Yes, we can! Should postmortem examinations in oncology be performed? Yes, we should! A postmortem analysis of oncological cases. Virchows Archiv. 2021;478(2):301-8.
Shankar P, Singh J, Joshi A, Malhotra AG, Shrivas A, Goel G, et al. Organ Involvement in COVID-19: A Molecular Investigation of Autopsied Patients. Microorganisms. 2022;10(7):1333.
Wichmann D, Sperhake J-P, Lütgehetmann M, Steurer S, Edler C, Heinemann A, et al. Autopsy Findings and Venous Thromboembolism in Patients With COVID-19. Annals of Internal Medicine. 2020;173(4):268-77.
Han T, Kang J, Li G, Ge J, Gu J. Analysis of 2019-nCoV receptor ACE2 expression in different tissues and its significance study. Annals of Translational Medicine. 2020;8(17).
Li M-Y, Li L, Zhang Y, Wang X-S. Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues. Infectious diseases of poverty. 2020;9(02):23-9.
Roshdy A, Zaher S, Fayed H, Coghlan JG. COVID-19 and the heart: a systematic review of cardiac autopsies. Frontiers in cardiovascular medicine. 2021;7:626975.
Schmit G, Lelotte J, Vanhaebost J, Horsmans Y, Van Bockstal M, Baldin P. The liver in COVID-19-related death: protagonist or innocent bystander? Pathobiology. 2021;88(1):88-94.
Díaz LA, Idalsoaga F, Cannistra M, Candia R, Cabrera D, Barrera F, et al. High prevalence of hepatic steatosis and vascular thrombosis in COVID-19: a systematic review and meta-analysis of autopsy data. World journal of gastroenterology. 2020;26(48):7693.
Barton LM, Duval EJ, Stroberg E, Ghosh S, Mukhopadhyay S. COVID-19 Autopsies, Oklahoma, USA. American Journal of Clinical Pathology. 2020;153(6):725-33.
Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet Respiratory Medicine. 2020;8(4):420-2.
Copin M-C, Parmentier E, Duburcq T, Poissy J, Mathieu D, Caplan M, et al. Time to consider histologic pattern of lung injury to treat critically ill patients with COVID-19 infection. Intensive Care Medicine. 2020;46(6):1124-6.
Hariri L, Hardin CC. Covid-19, Angiogenesis, and ARDS Endotypes. New England Journal of Medicine. 2020;383(2):182-3.
Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. New England Journal of Medicine. 2020;383(2):120-8.
Alberici F, Delbarba E, Manenti C, Econimo L, Valerio F, Pola A, et al. Management of Patients on Dialysis and With Kidney Transplantation During the SARS-CoV-2 (COVID-19) Pandemic in Brescia, Italy. Kidney International Reports. 2020;5(5):580-5.
Puelles VG, Lütgehetmann M, Lindenmeyer MT, Sperhake JP, Wong MN, Allweiss L, et al. Multiorgan and Renal Tropism of SARS-CoV-2. New England Journal of Medicine. 2020;383(6):590-2.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 AROOJ AHMAD, Shabbir H Chaudhry, BABAR HUSSAIN, M.UMAR FAROOQ, SANA ALI
This work is licensed under a Creative Commons Attribution 4.0 International License.
The articles published in this journal come under creative commons licence Attribution 4.0 International (CC BY 4.0) which allows to copy and redistribute the material in any medium or format Adapt — remix, transform, and build upon the material for any purpose, even commercially under following terms.
-
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
The editorial board of the Journal strives hard for the authenticity and accuracy of the material published in the Journal. However, findings and statements are views of the authors and do not necessarily represent views of the Editorial Board. Many software like (Google Maps, Google Earth, Biorender (free version)) restricts the free distribution of materials prepared using these softwares. Therefore, authors are strongly advised to check the license/copyright information of the software used to prepare maps/images. In case of publication of copyright material, the correction will be published in one of the subsequent issues of the Journal, and the authors will bear the printing cost.