Diffuse intravascular coagulation associated with COVID-19: histopathological findings in autopsy

Abstract

Abstract: 

Disseminated intravascular coagulation (DIC) occurs as a complication of a wide variety of disorders. COVID-19 may predispose tromboembolic disease due to excessive inflammation, hypoxia and immobilisation. The coagulation function in patients with SARS-CoV-2 is significantly deranged compared with healthy people. But due to the fact that thrombotic complications have not been analyzed collectively and compared to other viruses, there is not yet a safe conclusion as to whether SARS-CoV-2 is responsible for a worse rate of thrombotic manifestations, compared to other respiratory viruses, or not.

We present the histopathological findings of a rare case, in order to document and report DIC as a cause of death in patients with COVID-19 even in young patients without comorbidities. The case corresponds to an 18-year-old woman, without basic diseases, diagnosed with bilateral pneumonia due to COVID-19 who after hospital discharge presents gastrointestinal symptoms and dies at home. Autopsy is performed at the IMF and referred to the forensic pathology service for histopathological study of the brain, cerebellum, heart, lungs, liver, spleen and kidney. The processing of the materials was carried out by routine techniques and colored with hematoxylin-eosin. On macroscopic examination the organs showed congestive.  Microscopic examination exhibits the presence of microthrombos in the arterioles and capillaries of the lungs, kidney and heart. The importance of the case lies in communicating and learning more about thrombotic complications in COVID-19 patients, which are of utmost importance for considering thromboprophylaxis.