About: Megakaryocytes and platelet-fibrin thrombi characterize multi-organ thrombosis at autopsy in COVID-19: A case series

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About: Megakaryocytes and platelet-fibrin thrombi characterize multi-organ thrombosis at autopsy in COVID-19: A case series Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Megakaryocytes and platelet-fibrin thrombi characterize multi-organ thrombosis at autopsy in COVID-19: A case series
Creator	Adler, Nicole Berger, Jeffrey Carsons, Steven Charytan, David Gasmi, Billel Hochman, Judith Kleiner, David Mai, Xingchen Pittaluga, Stefania Rapkiewicz, Amy Reynolds, Harmony Thomas, Sarun
Source	Elsevier; Medline; PMC
abstract	BACKGROUND: There is increasing recognition of a prothrombotic state in COVID-19. Post-mortem examination can provide important mechanistic insights. METHODS: We present a COVID-19 autopsy series including findings in lungs, heart, kidneys, liver, and bone, from a New York academic medical center. FINDINGS: In seven patients (four female), regardless of anticoagulation status, all autopsies demonstrated platelet-rich thrombi in the pulmonary, hepatic, renal, and cardiac microvasculature. Megakaryocytes were seen in higher than usual numbers in the lungs and heart. Two cases had thrombi in the large pulmonary arteries, where casts conformed to the anatomic location. Thrombi in the IVC were not found, but the deep leg veins were not dissected. Two cases had cardiac venous thrombosis with one case exhibiting septal myocardial infarction associated with intramyocardial venous thrombosis, without atherosclerosis. One case had focal acute lymphocyte-predominant inflammation in the myocardium with no virions found in cardiomyocytes. Otherwise, cardiac histopathological changes were limited to minimal epicardial inflammation (n = 1), early ischemic injury (n = 3), and mural fibrin thrombi (n = 2). Platelet-rich peri‑tubular fibrin microthrombi were a prominent renal feature. Acute tubular necrosis, and red blood cell and granular casts were seen in multiple cases. Significant glomerular pathology was notably absent. Numerous platelet-fibrin microthrombi were identified in hepatic sinusoids. All lungs exhibited diffuse alveolar damage (DAD) with a spectrum of exudative and proliferative phases including hyaline membranes, and pneumocyte hyperplasia, with viral inclusions in epithelial cells and macrophages. Three cases had superimposed acute bronchopneumonia, focally necrotizing. INTERPRETATION: In this series of seven COVID-19 autopsies, thrombosis was a prominent feature in multiple organs, in some cases despite full anticoagulation and regardless of timing of the disease course, suggesting that thrombosis plays a role very early in the disease process. The finding of megakaryocytes and platelet-rich thrombi in the lungs, heart and kidneys suggests a role in thrombosis. FUNDING: None.
has issue date	2020-06-25(xsd:dateTime)
bibo:doi	10.1016/j.eclinm.2020.100434
bibo:pmid	32766543
has license	no-cc
sha1sum (hex)	5398e9b4c28e056eb1b296b7de4d43648af6e117
schema:url	https://doi.org/10.1016/j.eclinm.2020.100434
resource representing a document's title	Megakaryocytes and platelet-fibrin thrombi characterize multi-organ thrombosis at autopsy in COVID-19: A case series
has PubMed Central identifier	PMC7316051
has PubMed identifier	32766543
schema:publication	EClinicalMedicine
resource representing a document's body	covid:5398e9b4c28e056eb1b296b7de4d43648af6e117#body_text
is schema:about of	named entity 'mural' named entity 'glomerular' named entity 'ischemic injury' named entity 'One' named entity 'licenses' named entity 'license' named entity 'INJURY' named entity 'FOCAL' named entity 'LUNGS' named entity 'AUTOPSIES' named entity 'NECROTIZING' named entity 'FINDINGS' named entity 'NUMEROUS' named entity 'LIMITED' named entity 'IVC' named entity 'PULMONARY' named entity 'HEPATIC' named entity 'SEVEN' named entity 'ASSOCIATED WITH' named entity 'DISEASE COURSE' named entity 'THROMBI' named entity 'FOUND' named entity 'THE DEEP' named entity 'GRANULAR CASTS' named entity 'RED BLOOD CELL' named entity 'spectrum' named entity 'patients' named entity 'absent' named entity 'thrombi' named entity 'inclusions' named entity 'heart' named entity 'thrombi' named entity 'epicardial' named entity 'minimal' named entity 'lungs' named entity 'plays' named entity 'microthrombi' named entity 'viral' named entity 'pneumocyte' named entity 'bronchopneumonia' named entity 'focally' named entity 'fibrin' named entity 'necrotizing' named entity 'fibrin' named entity 'venous thrombosis' named entity 'thrombi' named entity 'kidneys' named entity 'inflammation' named entity 'anticoagulation' named entity 'hyaline' named entity 'autopsies' named entity 'Megakaryocytes' named entity 'epicardial' named entity 'hepatic' named entity 'thrombosis' named entity 'lungs' named entity 'lungs' named entity 'Megakaryocytes' named entity 'thrombi' named entity 'by-nc-nd' named entity 'platelet' named entity 'COVID' named entity 'anticoagulation therapy' named entity 'negative pressure' named entity 'microvasculature' named entity 'electron microscopy' named entity 'autopsy' named entity 'thrombosis' named entity 'thrombi' named entity 'COVID'

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