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13 February 2021 : Clinical Research

[Retracted] Autopsy and Histologic Findings of Patients with New Coronavirus Pneumonia: The Pathologic Associations with Hypoxemia

Heng Zhang1BCDEF, Jun Zhou1BCF, Rong Chen2BC, Yong Ren3BC, Jun Cai4BC, Lei Zhao4BC, Xiaochun Fei1BC, Zhenhua Liu5BC, Yu Zhang3BC, Ling Yuan3BC, Chaofu Wang1ADG*

DOI: 10.12659/MSM.928837

Med Sci Monit 2021; 27:e928837

Abstract

BACKGROUND: Coronavirus 2 (SARS-CoV-2) was declared a pandemic by the World Health Organization (WHO) in March 2020. To further reveal the pathologic associations between coronavirus and hypoxemia, we report the findings of 4 complete systematic autopsies of severe acute respiratory syndrome coronavirus 2-positive individuals who died of multiple organ failure caused by severe hypoxemia.

MATERIAL AND METHODS: We examined the donated corpses of 4 deceased patients who had been diagnosed with severe acute respiratory syndrome coronavirus 2. A complete post-mortem examination was carried out on each corpse, and multiple organs were macroscopically examined.

RESULTS: The 4 corpses were 2 males and 2 females, with an average age of 69 years. Bilateral lungs showed various degrees of atrophy and consolidation, with diffusely tough and solid texture in the sections. A thromboembolism was found in the main pulmonary artery extending into the atrium in 1 corpse, and significant atherosclerotic plaques tagged in the inner wall of the aortic arch were found in 2 corpses. Two corpses were found to have slightly atrophied bilateral renal parenchyma. Atrophic changes in the spleen were found in 2 corpses. Notably, there were significantly expanded alveolar septa and prominent fibroblastic proliferation.

CONCLUSIONS: The laboratory data of these corpses showed a progressive decrease in blood oxygen saturation, followed by refractory and irreversible hypoxemia. Clinical and laboratory information and autopsy and histologic presentations of multiple organs showed insufficient air exchange due to abnormalities in the respiratory system, and reduced erythropoiesis in bone marrow may play a role.

Keywords: Retracted Publication

Retraction note

SELECT DATE(`ARTICLE_DATE`.`DATE_MAIN`) AS `dat`, `JOUR_WWW_ARTICLES`.`ID_ARTICLE` FROM `JOUR_WWW_ARTICLES` INNER JOIN `ARTICLE_DATE` ON (`JOUR_WWW_ARTICLES`.`ID_ARTICLE` = `ARTICLE_DATE`.`ICID`) WHERE `ARTICLE_DATE`.`ID_DATE_KIND` = 5 AND `JOUR_WWW_ARTICLES`.`ID_PARENT_ARTICLE` =
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13 February 2021 : Clinical Research

[Retracted] Autopsy and Histologic Findings of Patients with New Coronavirus Pneumonia: The Pathologic Associations with Hypoxemia

Heng Zhang1BCDEF, Jun Zhou1BCF, Rong Chen2BC, Yong Ren3BC, Jun Cai4BC, Lei Zhao4BC, Xiaochun Fei1BC, Zhenhua Liu5BC, Yu Zhang3BC, Ling Yuan3BC, Chaofu Wang1ADG*

DOI: 10.12659/MSM.928837

Med Sci Monit 2021; 27:e928837

Abstract

BACKGROUND: Coronavirus 2 (SARS-CoV-2) was declared a pandemic by the World Health Organization (WHO) in March 2020. To further reveal the pathologic associations between coronavirus and hypoxemia, we report the findings of 4 complete systematic autopsies of severe acute respiratory syndrome coronavirus 2-positive individuals who died of multiple organ failure caused by severe hypoxemia.

MATERIAL AND METHODS: We examined the donated corpses of 4 deceased patients who had been diagnosed with severe acute respiratory syndrome coronavirus 2. A complete post-mortem examination was carried out on each corpse, and multiple organs were macroscopically examined.

RESULTS: The 4 corpses were 2 males and 2 females, with an average age of 69 years. Bilateral lungs showed various degrees of atrophy and consolidation, with diffusely tough and solid texture in the sections. A thromboembolism was found in the main pulmonary artery extending into the atrium in 1 corpse, and significant atherosclerotic plaques tagged in the inner wall of the aortic arch were found in 2 corpses. Two corpses were found to have slightly atrophied bilateral renal parenchyma. Atrophic changes in the spleen were found in 2 corpses. Notably, there were significantly expanded alveolar septa and prominent fibroblastic proliferation.

CONCLUSIONS: The laboratory data of these corpses showed a progressive decrease in blood oxygen saturation, followed by refractory and irreversible hypoxemia. Clinical and laboratory information and autopsy and histologic presentations of multiple organs showed insufficient air exchange due to abnormalities in the respiratory system, and reduced erythropoiesis in bone marrow may play a role.

Keywords: Retracted Publication

Retraction note

SELECT DATE(`ARTICLE_DATE`.`DATE_MAIN`) AS `dat`, `JOUR_WWW_ARTICLES`.`ID_ARTICLE` FROM `JOUR_WWW_ARTICLES` INNER JOIN `ARTICLE_DATE` ON (`JOUR_WWW_ARTICLES`.`ID_ARTICLE` = `ARTICLE_DATE`.`ICID`) WHERE `ARTICLE_DATE`.`ID_DATE_KIND` = 5 AND `JOUR_WWW_ARTICLES`.`ID_PARENT_ARTICLE` =
You have an error in your SQL syntax; check the manual that corresponds to your MySQL server version for the right syntax to use near '' at line 9
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Figures

Figure 1. (A) Lung consolidation. (B) Lung consolidation (SMA showed a hyperplasia of myofibroblasts). (C) Lung injury, pulmonary bullae. (D) Hyaline membrane (brown color highlighted by Masson’s stain). (E) Abundant serous exudation in the alveoli. (F) Cellulose exudation in the alveoli (brown color stained by Masson’s stain).Figure 2. (A) Mucus plugs located in the small airway. (B) Mucus plugs were blue when stained by AB-PAS. (C) Capillary endothelial cells shed (ERG was negative). (D) Thrombosis in the interstitial blood vessels and organization and recanalization were seen.Figure 3. (A, D) Alveolar epithelial cells shed and hyperplasia of type II alveolar epithelial cells. (B) AE1/AE3, (C) TTF-1, and, (E) CK7 showed type II alveolar epithelial cell hyperplasia. (F) 2019-nCoV-specific marker RN3-NP is expressed in hyperplastic type II alveolar epithelial cells.Figure 4. (A, B) Macrophage aggregation was found in the alveolar cavity, and type II alveolar epithelial cells were surrounded by cellulose exudates (type II alveolar epithelial cells labeled by AE1/AE3). (D) Macrophages were stained by CD68. (C, E, F) The 2019-nCoV-specific marker RN3-NP was expressed in hyperplastic macrophages.Figure 5. (A) Myocardial cell degeneration and necrosis. (B) Inflammatory infiltrated between cardiac striated muscle bundles. (C) Atrophy of myocardial cells, interstitial looseness, and edema. (D, E) Bone marrow hematopoietic function slightly decreased, and erythroid hyperplasia was lower than normal (MPO showed myeloid cells, CD235a showed erythroid cells). (F) Spleen phagocytosis (arrow).

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DOI: 10.12659/MSM.937048

Med Sci Monit 2022; 28:e937048

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750