Abstract
Objective: We aimed to evaluate histopathologic alterations in the lung,
heart, liver, and spleen of coronavirus disease 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 included in this postmortem case series.
Postmortem percutaneous ultrasound-guided biopsies using 14- and
16-gauge needles were performed in the lungs, heart, liver, and spleen.
Biopsy samples were stained with hematoxylin-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 patients,
and lung and spleen tissues were available from five and three patients,
respectively. Chest CT images predominantly revealed bibasilar
ground-glass opacities. Lung biopsies showed diffuse alveolar damage in
all biopsy specimens. Heart findings were nonspecific and largely
compatible with the underlying disease. Patchy necrosis, steatosis, and
mononuclear cellular infiltration were the main findings in the liver
biopsies. Splenic histopathological examination showed that splenic
necrosis and neutrophil infiltration were the common findings in all
patients. Conclusion: Tissue acquisition was complete for the heart and
liver and acceptable for lungs. The amount of tissue was sufficient for
a proper histopathologic examination. The histopathological findings
were generally in accordance with previous autopsy studies. The lung
radiological findings were also correlated with the histopathologic
findings. We consider that a postmortem biopsy is a feasible alternative
for histopathological examinations in COVID-19 decedents.