Evidence map›Paper›PMID 32443177›Full record

ArticleHistopathology2020

Pulmonary and systemic involvement in COVID-19 patients assessed with ultrasound-guided minimally invasive autopsy.

Amaro N Duarte-Neto, Renata A A Monteiro, Luiz F F da Silva, Denise M A C Malheiros, Ellen P de Oliveira, Jair Theodoro-Filho, João R R Pinho, Michele S Gomes-Gouvêa, Ana P M Salles, Ilka R S de Oliveira and 3 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Histopathology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 208 papers, 24 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
208citing papers in PubMed, 24 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

208 citing papers in PubMed, 24 syntheses or guidelines pooled it, 341 citations in OpenAlex.

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  6. COVID-19-Associated cardiac pathology at the postmortem evaluation: a collaborative systematic review.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2022
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  7. Guideline
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  9. Histopathological findings and clinicopathologic correlation in COVID-19: a systematic review.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2021
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  13. Autopsy findings in COVID-19-related deaths: a literature review.Forensic science, medicine, and pathology · 2021
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148 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 1 country.

Amaro N Duarte-NetoBIAS-Brazilian Image Autopsy Study Group, Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0001-6659-7186
Renata A A MonteiroBIAS-Brazilian Image Autopsy Study Group, Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Luiz F F da SilvaBIAS-Brazilian Image Autopsy Study Group, Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Denise M A C MalheirosBIAS-Brazilian Image Autopsy Study Group, Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Ellen P de OliveiraDepartamento de Cardiopneumologia, Instituto do Coração, São Paulo, Brazil.
Jair Theodoro-FilhoBIAS-Brazilian Image Autopsy Study Group, Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
João R R PinhoDepartamento de Gastroenterologia, LIM-07, São Paulo, Brazil.
Michele S Gomes-GouvêaDepartamento de Gastroenterologia, LIM-07, São Paulo, Brazil.
Ana P M SallesDepartamento de Gastroenterologia, LIM-07, São Paulo, Brazil.
Ilka R S de OliveiraDepartamento de Radiologia e Oncologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Thais MauadBIAS-Brazilian Image Autopsy Study Group, Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Paulo H N SaldivaBIAS-Brazilian Image Autopsy Study Group, Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Marisa DolhnikoffBIAS-Brazilian Image Autopsy Study Group, Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0002-9073-9989
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo · BRHospital do Coração · BRUniversidade de São Paulo · BR

Funding

Bill and Melinda Gates Foundation INV-002396Fundação de Amparo à Pesquisa do Estado de São Paulo 2013/17159-2
6 · The paper itself

Abstract

aimsBrazil ranks high in the number of coronavirus disease 19 (COVID-19) cases and the COVID-19 mortality rate. In this context, autopsies are important to confirm the disease, determine associated conditions, and study the pathophysiology of this novel disease. The aim of this study was to assess the systemic involvement of COVID-19. In order to follow biosafety recommendations, we used ultrasound-guided minimally invasive autopsy (MIA-US), and we present the results of 10 initial autopsies. METHODS AND

resultsWe used MIA-US for tissue sampling of the lungs, liver, heart, kidneys, spleen, brain, skin, skeletal muscle and testis for histology, and reverse transcription polymerase chain reaction to detect severe acute respiratory syndrome coronavirus 2 RNA. All patients showed exudative/proliferative diffuse alveolar damage. There were intense pleomorphic cytopathic effects on the respiratory epithelium, including airway and alveolar cells. Fibrinous thrombi in alveolar arterioles were present in eight patients, and all patients showed a high density of alveolar megakaryocytes. Small thrombi were less frequently observed in the glomeruli, spleen, heart, dermis, testis, and liver sinusoids. The main systemic findings were associated with comorbidities, age, and sepsis, in addition to possible tissue damage due to the viral infection, such as myositis, dermatitis, myocarditis, and orchitis.

conclusionsMIA-US is safe and effective for the study of severe COVID-19. Our findings show that COVID-19 is a systemic disease causing major events in the lungs and with involvement of various organs and tissues. Pulmonary changes result from severe epithelial injury and microthrombotic vascular phenomena. These findings indicate that both epithelial and vascular injury should be addressed in therapeutic approaches.

Indexed as

AdultAgedAged, 80 and overAutopsyBrazilCOVID-19FemaleHumansMaleMiddle AgedSARS-CoV-2UltrasonographyautopsyCOVID-19diffuse alveolar damagelung pathologyminimally invasive autopsySARS-CoV-2

Identifiers

PMID32443177
PMCPMC7280721
OpenAlexW3026167669

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.