![]() ![]() In pathology to describe these macroscopic changes in the lungs, which are also observed with various severe injuries and shock of any etiology, the term ‘shock lungs’ is used, which is not entirely correct for COVID-19 cases, since it does not imply damage to the vascular bed.Īt autopsy, the lungs are enlarged in volume and mass, with some mainly affected in the posterior basal sections (found in about a third of cases), meanwhile their front sections show an acute distention (lung tissue of increased airiness, pink color and crunches when cut).Ĭhanges in the lungs were macroscopically consistent with the concept of a ‘shock lung’. In turn, severe diffuse alveolar damage is synonymous with the clinical concept of acute respiratory distress syndrome (ARDS). ![]() The widely used term viral (interstitial) pneumonia inherently reflects the development of DAD, and with COVID-19 it should also include the pathology of the pulmonary vessels, primarily the microcirculatory ones (microangiopathy with thrombosis, rarely thrombovasculitis) and thrombosis and thromboemboli of large vessels with lungs hemorrhagic infarcts. The study showed that the main morphological presentation in the lungs is diffuse alveolar damage (DAD) combined with pathological changes in the pulmonary vascular bed and alveolar hemorrhagic syndrome. The -rate, shown by morphological and/or bacteriological testing, was 37% (746 out of 2,000 autopsies), which is slightly higher than the values typical, for example, of influenza A/H1N1 (about 30%). Autopsy revealed pathological changes in the lungs of varying severity and prevalence in all patients who died from COVID-19, however, there was a simultaneous damage to other organs, which in some cases could predominate over pulmonary changes and cause death.īacterial (or, rarely, mycotic) coinfection in the form of a viral and bacterial and mycotic (Klebsiella, Staphylococcus, Candida, etc.) pneumonia, as well as sepsis and septic shock, were more commonly present in patients who were on invasive mechanical ventilation for a long time (more than a week). ![]()
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