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Features of pathological anatomy of lungs at COVID-19

https://doi.org/10.18093/0869-0189-2020-30-5-519-532

Abstract

The research aim is to study the morphological features of COVID-19 in the lungs of patients who died in Moscow from March 20 to June 6, 2020. Methods. Autopsy material of the lungs from 123 deceased (54 women, 69 men) with COVID-19 coronavirus infection (confirmed by PCR) was analyzed, the median age was 71 (30 – 94) years, and the duration of the disease was 14 (3 – 65) days. In all cases, the patient’s medical records and autopsy reports were analyzed. Macro- and microscopic changes in the lungs were evaluated in all the observations. Results. The pathology of the lungs in COVID-19 corresponds to various phases of diffuse alveolar damage (DAD). The exudative phase of DAD was detected in 54 (43.9%), the proliferative phase – in 21 (14.63%), and their combination – in 51 (41.46%) of the deceased. Histological features of different phases of DAD are described. Conclusion. An analysis of autopsy material revealed a mismatch between the duration of the course of the disease and the phase of diffuse alveolar damage. A significant portion of the dead found a combination of exudative and proliferative phases of the disease. Histological signs that indirectly indicate a violation of the coagulation system during COVID-19 are described.

About the Authors

M. V. Samsonova
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; A.S.Loginov Moscow State Clinical and Research Center, Moscow Healthcare Department
Russian Federation

Mariya V. Samsonova – Doctor of Medicine, Head of Laboratory of Pathology and Immunology, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Senior Researcher, Laboratory of Pathomorphology, A.S.Loginov Moscow State Clinical and Research Center, Moscow Healthcare Department

Orekhovyy bul’var 28, Moscow, 115682
Shosse Entuziastov 86, Moscow, 111123
tel.: (495) 465-58-59 



A. L. Chernyaev
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Federal Research Institute of Human Morphology; N.I.Pirogov Russian State National Research Medical University, Healthcare Ministry of Russia
Russian Federation

Andrey L. Chernyaev – Doctor of Medicine, Professor, Head of Division of Basic Pulmonology, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Leading Researcher, Laboratory of Clinical Morphology, Federal Research Institute of Human Morphology; Professor, Department of Pathology and Clinical Morphology, Therapeutic Faculty, N.I.Pirogov Russian State National Research Medical University, Healthcare Ministry of Russia

Orekhovyy bul’var 28, Moscow, 115682
ul. Tsyurupy 3, Moscow, 117418
ul. Ostrovityanova 1, Moscow, 117997
tel.: (495) 465-58-59 



Zh. R. Omarova
N.I.Pirogov Russian State National Research Medical University, Healthcare Ministry of Russia
Russian Federation

Zhanna R. Omarova – Assistant Lecturer, Department of Pathological Anatomy and Clinical Pathological Anatomy, Pediatrics Faculty

ul. Ostrovityanova 1, Moscow, 117997
tel.: (495) 434-30-33 



E. A. Pershina
N.I.Pirogov City Hospital No.1 Moscow Health Department
Russian Federation

Ekaterina A. Pershina – Candidate of Medicine, Head of Radiation Diagnostics Center

Leninskiy prosp. 8, 119049, Moscow
tel.: (495) 633-79-15 



O. D. Mishnev
N.I.Pirogov Russian State National Research Medical University, Healthcare Ministry of Russia
Russian Federation

Oleko D. Mishnev – Doctor of Medicine, Professor, Head of Pathological Anatomy Department

ul. Ostrovityanova 1, Moscow, 117997
tel.: (905) 513-97-07 



O. V. Zayratyants
A.I.Evdokimov Moscow State University of Medicine and Dentistry, Healthcare Ministry of Russia
Russian Federation

Oleg V. Zayratyants – Doctor of Medicine, Professor, Head of the Department of Pathological Anatomy. SPIN: 4817-1084

ul. Delegatskaya 20, build. 1, Moscow, 127473
tel.: (903) 184-92-17 



L. M. Mikhaleva
Federal Research Institute of Human Morphology
Russian Federation

Liudmila M. Mikhaleva – Doctor of Medicine, Professor, Director, Head of Clinical Morphology Laboratory

ul. Tsyurupy 3, Moscow, 117418
tel.: (903) 621-44-57 



D. V. Kalinin
A.V.Vishnevsky National Medical Research Center for Surgery, Healthcare Ministry of Russia; I.V.Davydovsky City Clinical Hospital, Moscow Health Department
Russian Federation

Dmitry V. Kalinin – Candidate of Medicine, Head of Pathology Department, A.V.Vishnevsky National Medical Research Center for Surgery, Healthcare Ministry of Russia; pathologist, I.V.Davydovsky City Clinical Hospital, Moscow Health Department

ul. B. Serpukhovskaya, 27, Moscow, 117997
Yauzskaya ul. 11, Moscow, 109240
tel.: (964) 774-67-48 



V. V. Varyasin
State Institution “City Hospital No.52”, Moscow Health Department
Russian Federation

Valery V. Varyasin – Candidate of Medicine, Head of the Рathology Department

Pekhotnaya ul. 3, Moscow, 123182
tel.: (499) 196-19-71 



O. A. Tishkevich
Infectious Clinical Hospital No.2, Moscow Health Department
Russian Federation

Oleg A. Tishkevich – pathologist

8-уа ul. Sokolinoу gory 15, Moscow, 105275
tel.: (495) 365-00-58 



S. A. Vinogradov
«MEDSI group» Joint Stock Company
Russian Federation

Sergey A. Vinogradov – Head of the Pathology

vill. Otradnoe, 2, build. 1, Krasnogorsk, Moscow region, 143442
tel.: (495) 737-07-93 



K. Yu. Mikhaylichenko
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia
Russian Federation

Kirill Yu. Mikhaylichenko – Researcher, Laboratory of Pathology. SPIN: 1275-4522, Author ID: 1019147

Orekhovyy bul’var 28, Moscow, 115682
tel.: (968) 822-63-35 



A. V. Chernyak
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia
Russian Federation

Aleksandr V. Chernyak – Candidate of Medicine, Head of Laboratory of Functional and Ultra-sound Investigations. SPIN: 9328-6440, Author ID: 687383

Orekhovyy bul’var 28, Moscow, 115682
tel.: (917) 550-06-34



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Review

For citations:


Samsonova M.V., Chernyaev A.L., Omarova Zh.R., Pershina E.A., Mishnev O.D., Zayratyants O.V., Mikhaleva L.M., Kalinin D.V., Varyasin V.V., Tishkevich O.A., Vinogradov S.A., Mikhaylichenko K.Yu., Chernyak A.V. Features of pathological anatomy of lungs at COVID-19. PULMONOLOGIYA. 2020;30(5):519-532. https://doi.org/10.18093/0869-0189-2020-30-5-519-532

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ISSN 0869-0189 (Print)
ISSN 2541-9617 (Online)