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Introduction: Data on pathological changes in COVID-19 are scarce. The aim of this study was to describe the histopathological and virological findings of postmortem biopsies, and the existing clinical correlations, in people who died of COVID-19. Materials and Methods: We performed postmortem needle core biopsies of the chest in 11 people who died of COVID-19 pneumonia. Tissue examination was done by light microscopy and real-time polymerase chain reaction (RTPCR). Results: The age of the patients were between 61 to 94 years. Of the 11 postmortem chest biopsies, lung tissue was obtained in 8, myocardium tissue in 7, and liver tissue in 5. Histologically of lung, the main findings pertaining to the lung were diffuse alveolar damage in proliferative phase (n = 4, 50%), diffuse alveolar damage in exudative and proliferative phase (n = 3, 37.5%), diffuse alveolar damage in exudative (n=1; 12.5%) and acute pneumonia (n = 2, 25%). Necrotising pneumonia, acute fibrinous and organising pneumonia, and neutrophils were detected in one sample each (12.5%). Another case presented myocarditis. RT-PCR showed RNA of SARS-CoV-2 in 7 of the 8 lung samples (87.5%), 2 of the 7 myocardial tissue samples (28.6%), and 1 of the 5 liver tissue samples (20%). Conclusion: The postmortem examinations show diffuse alveolar damage, as well as acute or necrotising pneumonia. RT-PCR of SARS-CoV-2 was positive in most lung samples. [ABSTRACT FROM AUTHOR]

Background: The prevalence of multimorbidity and the number of chronic pathologies increases with age, and hospitalization rates are higher in very elderly patients. Aims: To identify predictors of mortality in patients aged 90 years or more at 6 and 12 months after admission to the internal medicine ward. Materials and methods: Prospective cohort study in patients aged 90 years or older whowere admitted to the internal medicine ward of Alicante General University Hospital from November 2018 to March 2019. We collected data for patient scores on the Barthel, Lawton-Brody, and Short Portable Mental Status Questionnaire; a nutritional questionnaire; the Charlson index; PALIAR and PROFUND prognostic indexes; and mortality at 6 and 12 months. Results: In the bivariate analysis adjusted for gender and comorbidity, malnutrition was associated with mortality at 6 and 12 months (odds ratio [OR] 5.17, 95% confidence interval [CI] 1.30, 20.50; OR 7.78, 95% CI 1.47, 40.9, respectively), as were moderate-severe cognitive impairment (6 months: OR 12.0, 95% CI 2.79, 52.0; 12 months: OR 10.73, 95% CI 2.40, 47.8) and high-risk scores on the PALIAR (6 months: OR 9.18, 95% CI 1.99, 42.27; 12 months: OR 11.7, 95% CI 2.62, 51.60) and PROFUND (6 months: OR 10.7, 95% CI 1.68, 68.80; 12 months: OR 20.9, 95% CI 3.15, 139.0) prognostic indexes. The Barthel index was associated with mortality only at 6 months (OR 6.16; 95% CI 1.69, 22.4). Conclusions: In nonagenarian inpatients, a worse score on the comprehensive assessment and a higher score on prognostic indexes were associated with increased risk of mortality at 6 and 12 months. [ABSTRACT FROM AUTHOR]