Abstract：
BACKGROUND: Coronavirus disease 2019 (COVID-19) has emerged as a pandemic for more than 2 years. Autopsy examination is an invaluable tool to understand the pathogenesis of emerging infections and their consequent mortalities. The aim of the current study was to present the lung and heart pathological findings of COVID-19-positive autopsies performed in Jordan.
METHODS: The study involved medicolegal cases, where the cause of death was unclear and autopsy examination was mandated by law. We included the clinical and pathologic findings of routine gross and microscopic examination of cases that were positive for COVID-19 at time of death. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed through molecular detection by real-time polymerase chain reaction, serologic testing for IgM and electron microscope examination of lung samples.
RESULTS: Seventeen autopsies were included, with male predominance (76.5%), Jordanians (70.6%), and 50 years as the mean age at time of death. Nine out of 16 cases (56.3%) had co-morbidities, with one case lacking such data. Histologic examination of lung tissue revealed diffuse alveolar damage in 13/17 cases (76.5%), and pulmonary microthrombi in 8/17 cases (47.1%). Microscopic cardiac findings were scarcely detected. Two patients died as a direct result of acute cardiac disease with limited pulmonary findings.
CONCLUSIONS: The detection of SARS-CoV-2 in postmortem examination can be an incidental or contributory finding which highlights the value of autopsy examination to determine the exact cause of death in controversial cases.
METHODS: The study involved medicolegal cases, where the cause of death was unclear and autopsy examination was mandated by law. We included the clinical and pathologic findings of routine gross and microscopic examination of cases that were positive for COVID-19 at time of death. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed through molecular detection by real-time polymerase chain reaction, serologic testing for IgM and electron microscope examination of lung samples.
RESULTS: Seventeen autopsies were included, with male predominance (76.5%), Jordanians (70.6%), and 50 years as the mean age at time of death. Nine out of 16 cases (56.3%) had co-morbidities, with one case lacking such data. Histologic examination of lung tissue revealed diffuse alveolar damage in 13/17 cases (76.5%), and pulmonary microthrombi in 8/17 cases (47.1%). Microscopic cardiac findings were scarcely detected. Two patients died as a direct result of acute cardiac disease with limited pulmonary findings.
CONCLUSIONS: The detection of SARS-CoV-2 in postmortem examination can be an incidental or contributory finding which highlights the value of autopsy examination to determine the exact cause of death in controversial cases.
摘要：
背景：2019年冠状病毒病（COVID-19）已经成为一种大流行超过2年。尸检检查是了解新出现感染的发病机理及其随之而来的死亡率的宝贵工具。本研究的目的是介绍在约旦进行的COVID-19阳性尸检的肺部和心脏病理学发现。
方法：该研究涉及法医学案例，死因不明确，法律规定进行尸检。我们纳入了死亡时COVID-19阳性病例的常规大体和显微镜检查的临床和病理结果。通过实时聚合酶链反应的分子检测确认了严重急性呼吸系统综合症冠状病毒2（SARS-CoV-2）的检测，IgM的血清学检测和肺样本的电子显微镜检查。
结果：包括17次尸检，男性占主导地位（76.5%），约旦人（70.6%），50岁是死亡时的平均年龄。16例中有9例(56.3%)有合并症,一个案例缺乏这样的数据。肺组织组织学检查发现13/17例（76.5%）弥漫性肺泡损伤，肺微血栓8/17例(47.1%)。几乎没有检测到显微镜下的心脏发现。两名患者死于急性心脏病，肺部表现有限。
结论：在尸检中发现SARS-CoV-2可能是偶然或共同的发现，这突出了尸检检查在有争议的病例中确定确切死亡原因的价值。
方法：该研究涉及法医学案例，死因不明确，法律规定进行尸检。我们纳入了死亡时COVID-19阳性病例的常规大体和显微镜检查的临床和病理结果。通过实时聚合酶链反应的分子检测确认了严重急性呼吸系统综合症冠状病毒2（SARS-CoV-2）的检测，IgM的血清学检测和肺样本的电子显微镜检查。
结果：包括17次尸检，男性占主导地位（76.5%），约旦人（70.6%），50岁是死亡时的平均年龄。16例中有9例(56.3%)有合并症,一个案例缺乏这样的数据。肺组织组织学检查发现13/17例（76.5%）弥漫性肺泡损伤，肺微血栓8/17例(47.1%)。几乎没有检测到显微镜下的心脏发现。两名患者死于急性心脏病，肺部表现有限。
结论：在尸检中发现SARS-CoV-2可能是偶然或共同的发现，这突出了尸检检查在有争议的病例中确定确切死亡原因的价值。
