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Postmortem Biopsies of the Lung, Heart, Liver, and Spleen of COVID-19 Patients
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  • Isil Yurdaisik,
  • Ahu Senem Demiroz,
  • Aysim Buge Oz,
  • Mustafa Akker,
  • Ayse Gul Agirman,
  • Suleyman Hilmi Aksoy,
  • Fuat Nurili
Isil Yurdaisik
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Ahu Senem Demiroz
Istanbul University-Cerrahpasa
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Aysim Buge Oz
Istanbul University-Cerrahpasa
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Mustafa Akker
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Ayse Gul Agirman
Istanbul Dr Siyami Ersek Gogus Kalp ve Damar Cerrahisi Egitim ve Arastirma Hastanesi
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Suleyman Hilmi Aksoy
Hisar Intercontinental Hospital
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Fuat Nurili
Memorial Sloan Kettering Cancer Center
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Abstract

Objective: We aimed to evaluate histopathologic alterations in the lung, heart, liver, and spleen of coronavirus disease 2019 (COVID-19) decedents through postmortem core needle biopsies. Materials and Methods: Patients who died of reverse transcription-polymerase chain reaction-proven COVID-19 were included in this postmortem case series. Postmortem percutaneous ultrasound-guided biopsies using 14- and 16-gauge needles were performed in the lungs, heart, liver, and spleen. Biopsy samples were stained with hematoxylin-eosin and examined under a light microscope. Clinicodemographic characteristics, chest computed tomography (CT) images, and COVID-19-related treatments of the patients were also collected. Results: Seven patients were included in this study. Liver and heart tissue samples were available from all patients, and lung and spleen tissues were available from five and three patients, respectively. Chest CT images predominantly revealed bibasilar ground-glass opacities. Lung biopsies showed diffuse alveolar damage in all biopsy specimens. Heart findings were nonspecific and largely compatible with the underlying disease. Patchy necrosis, steatosis, and mononuclear cellular infiltration were the main findings in the liver biopsies. Splenic histopathological examination showed that splenic necrosis and neutrophil infiltration were the common findings in all patients. Conclusion: Tissue acquisition was complete for the heart and liver and acceptable for lungs. The amount of tissue was sufficient for a proper histopathologic examination. The histopathological findings were generally in accordance with previous autopsy studies. The lung radiological findings were also correlated with the histopathologic findings. We consider that a postmortem biopsy is a feasible alternative for histopathological examinations in COVID-19 decedents.