COVID-19: Autopsy findings in six patients between 26 and 46 years of age.

Jun 7, 2021

Contributor: Selina Greuel,Jana Ihlow,Mihnea-Paul Dragomir,Simon Streit,Victor Max Corman,Linus Haberbosch,David Winkler,Jenny Meinhardt,Tom Aschman,Julia Schneider,Iryna Trotsyuk,Catarina Alisa Kunze,Lukas Maurer,Helena Radbruch,Frank L Heppner,David Horst,Sefer Elezkurtaj

COVID-19: Autopsy findings in six patients between 26 and 46 years of age.

Studies on the coronavirus disease 2019 (COVID-19) usually focus on middle aged and older adults. However, younger patients may present with severe COVID-19 and potentially fatal outcomes. For optimized, more specialized therapeutic regimens in this particular patient group, a better understanding of underlying pathomechanisms is of uttermost importance.
This study investigates relevant pre-existing medical conditions, clinical histories and autopsy findings, together with SARS-CoV-2-RNA, determined by qPCR, and laboratory data in six COVID-19 decedents at an age of 50 years or younger who were autopsied at the Charité University Hospital.
From a total of 76 COVID-19 patients who underwent an autopsy at our institution, 6 (7.9%) were 50 years old or younger. Most COVID-19 decedents of younger age presented with pre-existing medical conditions prior to SARS-CoV-2 infection. These included overweight and obesity, arterial hypertension, asthma, obstructive sleep apnea as well as graft-versus-host disease following cancer and bone marrow transplantation. Furthermore, clinical histories and autopsy results revealed a disproportionally high prevalence of thromboembolism and ischemic organ damage in this patient cohort. Histopathology and laboratory results indicated coagulopathies, signs of immune dysregulation and liver damage.
In conclusion, pre-existing health conditions may increase the risk of severe and fatal COVID-19 in younger patients who may be especially prone to developing thromboembolic complications, immune dysregulation and liver damage.

Copyright © 2021. Published by Elsevier Ltd.

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About The Expert

Selina Greuel

Institute of Pathology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.

Jana Ihlow

Institute of Pathology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany. Electronic address: jana.ihlow@charite.de.

Mihnea-Paul Dragomir

Institute of Pathology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.

Simon Streit

Department of Neuropathology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.

Victor Max Corman

Institute of Virology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; German Center for Infection Research (DZIF), 10117 Berlin, Germany.

Linus Haberbosch

Department of Endocrinology and Metabolic Diseases, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.

David Winkler

Institute of Pathology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.

Jenny Meinhardt

Department of Neuropathology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.

Tom Aschman

Department of Neuropathology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.

Julia Schneider

Institute of Virology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; German Center for Infection Research (DZIF), 10117 Berlin, Germany.

Iryna Trotsyuk

Institute of Pathology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.

Catarina Alisa Kunze

Institute of Pathology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.

Lukas Maurer

Department of Endocrinology and Metabolic Diseases, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.

Helena Radbruch

Department of Neuropathology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.

Frank L Heppner

Department of Neuropathology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; Cluster of Excellence, NeuroCure, 10117 Berlin, Germany; German Center for Neurodegenerative Diseases (DZNE) Berlin, 10117 Berlin, Germany.

David Horst

Institute of Pathology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.

Sefer Elezkurtaj

Institute of Pathology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.

References

PubMed