背景:这篇文章是全球最早的尸检报告之一,与COVID-19感染和肺脂肪栓塞相关。
目的:指出由冠状病毒2(SARS-CoV-2)感染引起的严重急性呼吸道综合症与肺脂肪栓塞之间的关键联系,这是严重COVID-19症状的可能主要机制之一。
方法:肺,16例完整人体尸检病例的脑和肾组织检查。所有死者都患有COVID-19感染,他们都没有在死前入院,死亡的直接原因各不相同。进行尸体解剖,并进行微生物学检查和使用油红O染色的组织学检查。因此,我们实施了一个由16名无肺部感染和各种直接死亡原因的死者组成的对照队列.
结果:在16例尸检病例中,男性11人(68.8%),女性5人(31.3%),总体平均年龄68.1(39-86)岁。研究对象的死亡原因是自然的,主要来自呼吸衰竭(在12例中,75%)。心肺复苏7例(43.8%)。没有解剖的人有更大的身体创伤迹象。肺脂肪栓塞11例(68.8%),在8例患者中推广到肾脏(所有病例的50%,72.3%的病例伴有肺脂肪栓塞)和脑组织1例。
结论:我们证明了COVID-19疾病与各种严重脂肪栓塞之间的合理关系,其严重程度与体重不直接相关。需要考虑对COVID-19患者进行进一步调查,甚至改变药物治疗。
BACKGROUND: The article is one of the very first autopsy reports worldwide, which associates COVID-19 infection and pulmonary fat embolism.
OBJECTIVE: To point to a crucial connection between a severe acute respiratory syndrome caused by coronavirus 2 (SARS-CoV-2) infection and pulmonary fat embolism as one of the possible major mechanisms of severe COVID-19 symptoms.
METHODS: Lung, brain and kidney tissues examination of 16 full human autopsy cases. All deceased suffered from COVID-19 infection, none of them was admitted to hospital prior to death, immediate causes of death vary. Autopsies accompanied by microbiological examination and histological examination using Oil Red O staining were performed. Consequently, we have implemented a control cohort consisting of 16 deceased with no presence of pulmonary infection and various immediate causes of death.
RESULTS: Of the 16 autopsy cases, 11 (68.8%) were males and 5 (31.3%) females, with overall mean age 68.1 (39-86) years. Causes of death of studied subjects were natural, mostly from respiratory failure (in 12 cases, 75%). Cardiopulmonary resuscitation was performed in 7 cases (43.8%). None of dissected persons had larger signs of body trauma. Pulmonary fat embolism was found in 11 cases (68.8%), which generalised to kidneys in 8 patients (50% of all cases, 72.3% of cases with pulmonary fat embolism) and to brain tissue in 1 case.
CONCLUSIONS: We demonstrated a reasonable relation between a COVID-19 disease and a variously severe fat embolism, severity of which does not directly correlate with body weight. Further investigation or even change of medical treatment needs to be considered in patients with COVID-19.