Skip to main content
Erschienen in: Virchows Archiv 3/2020

09.07.2020 | COVID-19 | Editorial Zur Zeit gratis

Unlocking the lockdown of science and demystifying COVID-19: how autopsies contribute to our understanding of a deadly pandemic

verfasst von: Alexandar Tzankov, Danny Jonigk

Erschienen in: Virchows Archiv | Ausgabe 3/2020

Einloggen, um Zugang zu erhalten

Excerpt

A rapidly evolving sweeping pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leading to coronavirus disease 2019 (COVID-19) has dominated the first half of 2020 and continues to do so. Cases of COVID-19 were first described in late 2019, when a series of previously unidentified pneumonia-related deaths emerged in Hubei province, China [1]. COVID-19, subsequently spread to almost all countries with a current count of > 11.5 million cases and > 535,000 confirmed deaths worldwide (https://​www.​worldometers.​info/​coronavirus/​). Although virus’ origin, cellular entry and epidemiology [24] have rapidly been clarified, in situ observations of the actual viral interactions within human organs and tissues in patients suffering from COVID-19 have for a long time been addressed at the level of case reports or small series of ≤ 4 cases, as reviewed by Calabrese et al. [5] in the current issue of Virchows Archiv. Indeed, by the end of April 2020 when 150,000 patients had already died of COVID-19, only 16 autopsy cases had been reported in the peer-reviewed literature, with nine publications presenting limited autopsies, assessment of postmortem core-needle or incisional collections of tissue. In the absence of reliable data regarding the degree of SARS-CoV-2 infectivity in dead individuals, various authorities discouraged the conduction of autopsies. This, combined with the ill-adjusted attitudes of pathologists, clinicians and societies towards autopsies, locked down scientific activities to elucidate the actual underlying mechanisms of COVID-19 [6]. This seems incomprehensible, given the fundamental and time-proven role of autopsies in re-emerging, emerging or unknown diseases [e.g., 7]. Only after 170,000 reported COVID-19 deaths and 4 months of pandemic, the first autopsy series of > 10 patients (n = 21) was put forward published [8], and only after another 280,000 deaths and one more month, finally a series of > 50 patients (n = 80) was released [9]. …
Literatur
1.
Zurück zum Zitat Chen N, Zhou M, Dong X et al (2020) Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 395:507–513 Chen N, Zhou M, Dong X et al (2020) Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 395:507–513
2.
Zurück zum Zitat Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF (2020) The proximal origin of SARS-CoV-2. Nat Med 26:450–452CrossRef Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF (2020) The proximal origin of SARS-CoV-2. Nat Med 26:450–452CrossRef
3.
Zurück zum Zitat Hoffmann M, Kleine-Weber H, Schroeder S et al (2020) SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 181:271–280 Hoffmann M, Kleine-Weber H, Schroeder S et al (2020) SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 181:271–280
4.
Zurück zum Zitat Sun J, He WT, Wang L et al (2020) COVID-19: epidemiology, evolution, and cross-disciplinary perspectives. Trends Mol Med 26:483–495 Sun J, He WT, Wang L et al (2020) COVID-19: epidemiology, evolution, and cross-disciplinary perspectives. Trends Mol Med 26:483–495
6.
Zurück zum Zitat Salerno M, Sessa F, Piscopo A et al (2020) No autopsies on COVID-19 deaths: a missed opportunity and the lockdown of science. J Clin Med 9:E1472CrossRef Salerno M, Sessa F, Piscopo A et al (2020) No autopsies on COVID-19 deaths: a missed opportunity and the lockdown of science. J Clin Med 9:E1472CrossRef
7.
Zurück zum Zitat Reye RDK, Morgan G, Baral J (1963) Encephalopathy and fatty degeneration of the viscera: a disease entity in childhood. Lancet II:749–752CrossRef Reye RDK, Morgan G, Baral J (1963) Encephalopathy and fatty degeneration of the viscera: a disease entity in childhood. Lancet II:749–752CrossRef
8.
Zurück zum Zitat Menter T, Haslbauer JD, Nienhold R et al (2020) Post-mortem examination of COVID19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings of lungs and other organs suggesting vascular dysfunction. Histopathology. https://doi.org/10.1111/his.14134 Menter T, Haslbauer JD, Nienhold R et al (2020) Post-mortem examination of COVID19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings of lungs and other organs suggesting vascular dysfunction. Histopathology. https://​doi.​org/​10.​1111/​his.​14134
9.
Zurück zum Zitat Edler C, Schröder AS, Aepfelbacher M et al (2020) Dying with SARS-CoV-2 infection-an autopsy study of the first consecutive 80 cases in Hamburg, Germany. Int J Legal Med 134:1275–1284 Edler C, Schröder AS, Aepfelbacher M et al (2020) Dying with SARS-CoV-2 infection-an autopsy study of the first consecutive 80 cases in Hamburg, Germany. Int J Legal Med 134:1275–1284
10.
Zurück zum Zitat Heinrich F, Sperhake J, Heinemann A et al (2020) Germany’s first COVID-19 deceased: a 59-year old man presenting with diffuse alveolar damage due to SARS-CoV-2 infection. Virchows Arch Heinrich F, Sperhake J, Heinemann A et al (2020) Germany’s first COVID-19 deceased: a 59-year old man presenting with diffuse alveolar damage due to SARS-CoV-2 infection. Virchows Arch
12.
Zurück zum Zitat Bösmüller H, Traxler S, Bitzer M et al (2020) The evolution of pulmonary pathology in fatal COVID-19 disease. An autopsy study with clinical correlation. Virchows Arch 10.1007/s00428-020-02881-x Bösmüller H, Traxler S, Bitzer M et al (2020) The evolution of pulmonary pathology in fatal COVID-19 disease. An autopsy study with clinical correlation. Virchows Arch 10.1007/s00428-020-02881-x
Metadaten
Titel
Unlocking the lockdown of science and demystifying COVID-19: how autopsies contribute to our understanding of a deadly pandemic
verfasst von
Alexandar Tzankov
Danny Jonigk
Publikationsdatum
09.07.2020
Verlag
Springer Berlin Heidelberg
Schlagwort
COVID-19
Erschienen in
Virchows Archiv / Ausgabe 3/2020
Print ISSN: 0945-6317
Elektronische ISSN: 1432-2307
DOI
https://doi.org/10.1007/s00428-020-02887-5

Weitere Artikel der Ausgabe 3/2020

Virchows Archiv 3/2020 Zur Ausgabe

Neu im Fachgebiet Pathologie