CHEST Guidelines-A-Call-to-Action_2020

A-Call-to-Action_2020_chest (1)

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The document is a call to action by Rolf F. Barth, MD, Xinyang Xu, DO, and L. Maximilian Buja, MD, advocating for detailed autopsies of patients who have died from COVID-19. The authors stress the importance of these autopsies to understand organ involvement beyond the commonly known lung infection caused by the SARS-CoV-2 virus. They point to a limited number of reports detailing autopsy findings, highlighting that only gross autopsies in a few cases have been documented and often lack histopathologic examination.<br /><br />Two notable cases of complete autopsies shed light on critical insights. One pathologic report described diffuse alveolar damage in lungs of a COVID-19 decedent, and another identified interstitial lymphocytic infiltrates and atypical changes in lung tissue suggestive of viral infection. Additional observations included inflammatory infiltrates in the heart and microscopic changes in the liver, although these could be unrelated to COVID-19. The authors emphasize the potential involvement of other organs such as the gastrointestinal tract and nervous system, the latter possibly contributing to respiratory failure.<br /><br />The authors draw parallels with the pathological analysis of SARS, suggesting similar comprehensive reviews for COVID-19 to enhance disease understanding. They lament the decline in autopsies globally, underscoring their invaluable role in learning how emerging diseases affect multiple organ systems, which could improve treatment. The document concludes with a hope that more detailed autopsy reports will guide medical professionals in developing better treatment strategies, recognizing the absence of conflicts of interest and expressing gratitude for assistance in preparing the publication.

Keywords

COVID-19

autopsies

SARS-CoV-2

organ involvement

pathological analysis

diffuse alveolar damage

histopathologic examination

inflammatory infiltrates

emerging diseases

treatment strategies