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Clinical characteristics and histopathology of COVID-19 related deaths in South African adults
- Source :
- PLoS ONE, Vol 17, Iss 1, p e0262179 (2022), PLoS ONE
- Publication Year :
- 2022
- Publisher :
- Public Library of Science (PLoS), 2022.
-
Abstract
- Comparisons of histopathological features and microbiological findings between decedents with respiratory symptoms due to SARS-CoV-2 infection or other causes, in settings with high prevalence of HIV and Mycobacterium tuberculosis (MTB) infections have not been reported. Deaths associated with a positive ante-mortem SARS-CoV-2 PCR test and/or respiratory disease symptoms at Chris Hani Baragwanath Academic Hospital in Soweto, South Africa from 15th April to 2nd November 2020, during the first wave of the South African COVID-19 epidemic, were investigated. Deceased adult patients had post-mortem minimally-invasive tissue sampling (MITS) performed to investigate for SARS-CoV-2 infection and molecular detection of putative pathogens on blood and lung samples, and histopathology examination of lung, liver and heart tissue. During the study period MITS were done in patients displaying symptoms of respiratory disease including 75 COVID-19-related deaths (COVID+) and 42 non-COVID-19-related deaths (COVID-). The prevalence of HIV-infection was lower in COVID+ (27%) than in the COVID- (64%), MTB detection was also less common among COVID+ (3% vs 13%). Lung histopathology findings showed differences between COVID+ and COVID- in the severity of the morphological appearance of Type-II pneumocytes, alveolar injury and repair initiated by SARS-CoV-2 infection. In the liver necrotising granulomatous inflammation was more common among COVID+. No differences were found in heart analyses. The prevalence of bacterial co-infections was higher in COVID+. Most indicators of respiratory distress syndrome were undifferentiated between COVID+ and COVID- except for Type-II pneumocytes. HIV or MTB infection does not appear in these data to have a meaningful correspondence with COVID-related deaths. Funding Information: This study was supported by the Bill & Melinda Gates Foundation (grant number INV-016202). There was also partial support from the Department of Science and Technology and National Research Foundation: South African Research Chair Initiative in Vaccine Preventable Diseases; and the South African Medical Research Council. Declaration of Interests: All other authors have nothing to disclose. Ethics Approval Statement: The study was approved by the Human Research Ethics Committee at the University of the Witwatersrand (HREC approval number: M200313). Informed consent was obtained from relatives of the deceased.
- Subjects :
- Male
RNA viruses
Viral Diseases
Pulmonology
Coronaviruses
Physiology
Respiratory System
Comorbidity
Pneumocytes
South Africa
Medical Conditions
Informed consent
Medicine and Health Sciences
Respiratory system
Immune Response
Pathology and laboratory medicine
Virus Testing
Multidisciplinary
biology
Respiratory distress
Respiratory disease
Middle Aged
Medical microbiology
Actinobacteria
medicine.anatomical_structure
Infectious Diseases
COVID-19 Nucleic Acid Testing
Hypertension
Viruses
Medicine
Vaccine-preventable diseases
Female
Autopsy
SARS CoV 2
Pathogens
Anatomy
Research Article
Adult
medicine.medical_specialty
SARS coronavirus
Science
Immunology
Alveoli
Real-Time Polymerase Chain Reaction
Microbiology
Mycobacterium tuberculosis
Respiratory Disorders
Signs and Symptoms
Diagnostic Medicine
Internal medicine
medicine
Diabetes Mellitus
Humans
Respiratory Physiology
Pandemics
Aged
Inflammation
Lung
Biology and life sciences
Bacteria
business.industry
SARS-CoV-2
Organisms
Viral pathogens
COVID-19
Covid 19
Length of Stay
biology.organism_classification
medicine.disease
Microbial pathogens
Alveolar Epithelial Cells
Respiratory Infections
Histopathology
Biopsy, Large-Core Needle
Clinical Medicine
business
Mycobacterium Tuberculosis
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 17
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....9481185a90a26f79f08818360e6acaf7