Interstitial Capillary Congestion and Diffuse Alveolar Damage: Incidental or Factual Findings in the Lungs of Autopsy Cases Positive for Coronavirus Disease-19.

Abstract

Background: Interstitial capillary congestion and diffuse alveolar damage (DAD) were frequently observed in patients who died from Coronavirus disease-19 (COVID-19). The research question pertains to observing these findings in COVID-19-positive patients lacking pulmonary symptoms. The histological examination of lung samples from COVID-19-positive patients who do not succumb to COVID-19-related pulmonary complications can provide an answer. This study analyzed postmortem lung autopsy samples from individuals who did not succumb to COVID-19-related pulmonary complications. The research article aimed to examine the morphological variations in postmortem lung samples of COVID-19 patients who did not succumb to the disease, and to compare these changes with those observed in cases of COVID-19-related deaths, utilizing existing English literature.

Methodology: This prospective study included subjects who died without complications from COVID-19-related injuries, had positive real-time polymerase chain reaction throat swabs, and exhibited no pulmonary manifestation of COVID-19 disease. A comprehensive histomorphological analysis of the lung samples was conducted.

Results: A total of 20 subjects were enrolled in this study. Capillary congestion was the most prevalent histomorphological change observed in lung autopsies, seen in 90% (18/20) of cases, followed by emphysema in 75% (15/20) and the acute phase of DAD in 25% (5/20) of cases. Acute bronchopneumonia and fibrotic nodules were identified in 20% (4/20) and 10% (2/20) of the study population, respectively.

Conclusion: In postmortem lung autopsy of COVID-19-positive patients lacking symptomatic pulmonary issues, capillary congestion, diffuse alveolar destruction, and emphysema were prevalent. The findings indicate that COVID-19 exhibits varied responses to damage and inflammation that do not correlate with mortality. This study enhances the understanding of pathophysiological lung tissue variations in COVID-19 patients who have non-COVID-19-related deaths, potentially educating forensic pathologists and supporting future research endeavors.