Postmortem biopsies of the lung, heart, liver, and spleen of COVID-19 patients

Abstract

Objective

We aimed to evaluate histopathologic alterations in the lung, heart, liver, and spleen of coronavirus 2019 (COVID-19) decedents through postmortem core needle biopsies.

Materials and methods

Patients who died of reverse transcription-polymerase chain reaction-proven COVID-19 were this postmortem case series. Postmortem percutaneous ultrasound-guided biopsies of the lungs, and spleen were performed using 14-and 16-gauge needles. Biopsy samples were stained with eosin and examined under a light microscope. Clinicodemographic characteristics, chest computed tomography (CT) images, and COVID-19-related treatments of the patients were also collected.

Results

Seven patients were included in this study. Liver and heart tissue samples were available from all and lung and spleen tissue samples were available from five and three patients, respectively. Chest images predominantly revealed bibasilar ground-glass opacities. Lung biopsies showed diffuse damage in all biopsy specimens. Heart findings were nonspecific and largely compatible with the disease. Patchy necrosis, steatosis, and mononuclear cell infiltration were the main findings in biopsies. Splenic histopathological examination showed that splenic necrosis and neutrophil infiltration were common findings in all patients.

Conclusion

Tissue acquisition was complete for the heart and liver and acceptable for the lungs. The amount was sufficient for a proper histopathologic examination. Histopathological findings were generally accordance with previous autopsy studies. Radiological findings of the lung were also correlated histopathologic findings. We consider that a postmortem biopsy is a feasible alternative for histopathological examinations in COVID-19 decedents.