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Younger age is associated with cardiovascular pathological phenotype of severe COVID-19 at autopsy

Title: Younger age is associated with cardiovascular pathological phenotype of severe COVID-19 at autopsy
Authors: Fernando R. Giugni; Amaro N. Duarte-Neto; Luiz Fernando F. da Silva; Renata A. A. Monteiro; Thais Mauad; Paulo H. N. Saldiva; Marisa Dolhnikoff
Source: Frontiers in Medicine, Vol 10 (2024)
Publisher Information: Frontiers Media S.A.
Publication Year: 2024
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: children; MIS-C; myocarditis; pathology; SARS-CoV-2; Medicine (General); R5-920
Description: IntroductionCOVID-19 affects patients of all ages. There are few autopsy studies focusing on the younger population. We assessed an autopsy cohort aiming to understand how age influences pathological outcomes in fatal COVID-19.MethodsThis study included autopsied patients, aged 6 months to 83 years, with confirmed COVID-19 in 2020–2021. We collected tissue samples from deceased patients using a minimally invasive autopsy protocol and assessed pathological data following a systematic approach.ResultsEighty-six patients were included, with a median age of 55 years (IQR 32.3–66.0). We showed that age was significantly lower in patients with acute heart ischemia (p = 0.004), myocarditis (p = 0.03) and lung angiomatosis (p < 0.001), and significantly higher in patients with exudative diffuse alveolar damage (p = 0.02), proliferative diffuse alveolar damage (p < 0.001), lung squamous metaplasia (p = 0.003) and lung viral atypia (p = 0.03), compared to patients without those findings. We stratified patients by their age and showed that cardiovascular findings were more prevalent in children and young adults. We performed principal component analysis and cluster of pathological variables, and showed that cardiovascular variables clustered and covariated together, and separated from pulmonary variables.ConclusionWe showed that age modulates pathological outcomes in fatal COVID-19. Younger age is associated with cardiovascular abnormalities and older age with pulmonary findings.
Document Type: article in journal/newspaper
Language: English
Relation: https://www.frontiersin.org/articles/10.3389/fmed.2023.1327415/full; https://doaj.org/toc/2296-858X; https://doaj.org/article/fb51d362259e4c50bfd12846f110bc7b
DOI: 10.3389/fmed.2023.1327415
Availability: https://doi.org/10.3389/fmed.2023.1327415; https://doaj.org/article/fb51d362259e4c50bfd12846f110bc7b
Accession Number: edsbas.A79CE55F
Database: BASE