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Filograna L, Grassi S, Manenti G, Di Donna C, Tatulli D, Nardoni F, Masini V, Ausania F, Grassi VM, Floris R, Colosimo C, Arena V, Pascali VL, Oliva A. Postmortem CT pulmonary findings in SARS-CoV-2-positive cases: correlation with lung histopathological findings and autopsy results. Int J Legal Med 2022; 136:1407-1415. [PMID: 35157128 PMCID: PMC8853405 DOI: 10.1007/s00414-022-02793-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 01/26/2022] [Indexed: 12/12/2022]
Abstract
Introduction/purpose Postmortem computed tomography (PMCT) is a valuable tool for analyzing the death of patients with SARS-CoV-2 infection. The purpose of this study was to investigate the correlation between PMCT lung findings in autopsy cadavers positive for SARS-CoV-2 infection and the severity of COVID-19 lung disease by histopathological analysis. Materials and methods We reviewed chest PMCT findings, paying particular attention to the lung parenchyma, in 8 autopsy cases positive for SARS-CoV-2. Correlations between chest PMCT and histopathological findings were assessed. Clinical conditions and comorbidities were also recorded and discussed. The primary cause of death was finally considered. Results In 6/8 cases, pulmonary PMCT findings were massive consolidation (4/8) and bilateral diffuse mixed densities with a crazy-paving pattern (2/8). These cases showed severe pulmonary signs of COVID-19 at histopathological analysis. In the remaining 2/8 cases, pulmonary PMCT findings were scant antideclive ground-glass opacities in prevalent gradient densities attributed to hypostasis. In 4/8 cases with massive consolidations, important comorbidities were noted. In 6/8 cases with severe pulmonary histopathological signs of lung COVID-19, autopsy found that the cause of death was cardiorespiratory failure. In the remaining 2/8 cases, histopathological analysis revealed lung alterations due to edema and some signs of SARS-CoV-2 infection; the cause of death was not attributed to SARS-CoV-2 infection (Table 1). Discussion and conclusion Chest PMCT findings correlate with the severity of COVID-19 lung disease at histopathology examination. According to our results, there may also be a relationship between cause of death and PMCT findings in COVID-19, which must be critically analyzed considering clinical antemortem data.
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Affiliation(s)
- Laura Filograna
- Department of Integrated Care Processes, Diagnostic Imaging Area, Tor Vergata University, PTV Policlinico Tor Vergata, Viale Oxford 81, 00133, FondazioneRome, Italy.
| | - Simone Grassi
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Guglielmo Manenti
- Department of Integrated Care Processes, Diagnostic Imaging Area, Tor Vergata University, PTV Policlinico Tor Vergata, Viale Oxford 81, 00133, FondazioneRome, Italy
| | - Carlo Di Donna
- Department of Integrated Care Processes, Diagnostic Imaging Area, Tor Vergata University, PTV Policlinico Tor Vergata, Viale Oxford 81, 00133, FondazioneRome, Italy
| | - Doriana Tatulli
- Department of Integrated Care Processes, Diagnostic Imaging Area, Tor Vergata University, PTV Policlinico Tor Vergata, Viale Oxford 81, 00133, FondazioneRome, Italy
| | - Francesco Nardoni
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Valentina Masini
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology - Diagnostic Imaging Area, Catholic University of Sacred Heart, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Francesco Ausania
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Vincenzo Maria Grassi
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Roberto Floris
- Department of Integrated Care Processes, Diagnostic Imaging Area, Tor Vergata University, PTV Policlinico Tor Vergata, Viale Oxford 81, 00133, FondazioneRome, Italy
| | - Cesare Colosimo
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology - Diagnostic Imaging Area, Catholic University of Sacred Heart, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Vincenzo Arena
- Department of Woman and Child Health and Public Health, Area of Pathology, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Vincenzo Lorenzo Pascali
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Antonio Oliva
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito, 1, 00168, Rome, Italy
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