Pathology of the organ lesions caused by Covid-19 disease

Lotz Gábor (1), Danics Krisztina (2), Pesti Adrián (1), Várkonyi Tibor (1), Dobi Deján (1), Vályi-Nagy István (3), Törő Klára (2), Glasz Tibor (1), Kiss András (1), Schaff Zsuzsa (1)
(1) Semmelweis Egyetem, 2. Sz. Patológiai Intézet, Budapest
(2) Semmelweis Egyetem, Igazságügyi és Biztosítás-orvostani Intézet, Budapest
(3) Dél-pesti Centrumkórház, Országos Hematológiai és Infektológiai Intézet, Budapest

The severity of Covid-19 disease caused by the SARS-CoV-2 virus ranges from asymptomatic to viral respiratory illness to the development of systemic disease that can be fatal in a fewdays. Predisposing factors for more severe disease include old age, male gender, obesity, diabetes, hypertension, chronic heart and lung disease, malignancies. Patients may subsequently suffer from post-Covid symptoms, e.g. persistent cough, olfactory/taste disturbance, musculoskeletal pain, fatigue, sleep, brain function, mood or mental disorders, cardiovascular symptoms, etc. Post mortem examination of victims of the disease can also contribute significantly to a better understanding of Covid-19. Our experience suggests that when the viral infection itself is the underlying disease without more severe comorbidities, death is usually due to respiratory failure. Where there is other serious underlying disease (e.g. chronic heart failure), a minor degree of viral pneumonia may contribute to its decompensation, so Covid-19 is usually only a cofactor, a concomitant disease. Finally, there may be no causal link between the viral infection and the death of the patient (e.g. intestinal necrosis due to an excluded hernia), but SARS-CoV-2 positivity is also detected. Therefore, the combined analysis of clinical and autopsy data in patients who died from SARS-CoV-2 infection is the most correct way to establish the cause-of-death causal sequence and its association with the viral infection.

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