Pathological anatomy of 11 death cases of new coronary pneumonia

Pathological preliminary diagnosis of 3 cases showed mucus discharge in the lungs of the deceased

A team led by Liu Liang, a professor of forensic pathology at Tongji Medical College of Huazhong University of Science and Technology, completed an autopsy of the first death case of new coronary pneumonia at 3:50 on February 16. As of February 25, the expert team has completed the pathological anatomy of 11 death cases of neo-coronary pneumonia. Among them, Liu Liang's team has been responsible for 9 cases, and 3 cases have completed the preliminary diagnosis of pathology.

Liu Liang said that the lesions of new coronary pneumonia are similar to SARS and have their own characteristics. Judging from the current pathological results, some dead people can see mucus secretions on the section of their lungs. He believes that this is a place to be vigilant in clinical treatment-"If the mucus components are not resolved in the treatment, use The way of oxygen supply may not achieve the purpose, and sometimes it will have a reverse effect. When given positive pressure, the mucus may be pushed deeper and wider, which will increase the patient's hypoxia. "

Remains donor 52 years old

Beiqing Daily: How is the patho-anatomical work for new coronary pneumonia performed?

Liu Liang: From 16th to 25th, our team dissected 9 cases in total, and the Shanghai team dissected two cases in Wuhan. Remains donors have similar male to female ratios, with older ages ranging from 60, 70, and over 80. The youngest is 52.

Beiqing Daily: Generally speaking, how many comprehensive analyses are needed to reach a more scientific conclusion?

Wang Guoping: From a scientific perspective, the more, the better. At present, a total of 11 cases have been dissected, which can still explain the problem to a certain extent.

Beiqing Daily: Where is the autopsy performed?

Liu Liang: This autopsy was done in the operating room of the hospital. After soliciting the opinions of family members, in general, the dissection work will begin 6 to 8 hours after the death of the patient, and some will be later. All the remains of the autopsy were sent to the crematorium for cremation.

Mucous secretions from deceased's lungs

Beiqing Daily: Are there any cases where pathological studies have been completed?

Liu Liang: The preliminary results of 3 cases of pathological diagnosis have come out. More in-depth examinations, such as immunohistochemistry and special staining, are still being done.

From the current situation, there are still more important findings, but the conclusion needs to be further communicated with clinical experts to see whether these lesions are caused by clinical treatment or the disease itself.

Beiqing Daily: Judging from the autopsy, what other organs are affected by the new crown virus besides invading the lungs?

Liu Liang: The pathological changes of new coronary pneumonia certainly do not only damage the lungs, but also include the immune system and other organs of the body. Specific opinions must be exchanged with clinicians.

Beiqing Daily: Academician Zhong Nanshan previously said that the autopsy of patients with new coronary pneumonia found that the inflammation of the lungs was very severe and there was a large amount of mucus. What problems do these performances reflect? How does it help clinical treatment?

Liu Liang: Under the microscope, we did find some mucus secretions on the section of the lungs of the dead, which can remind clinical treatment to be vigilant.

The lungs are the place where oxygen and carbon dioxide are exchanged in the human body. Its function depends on the airway being unobstructed and the alveoli function better. At present, the function of the alveoli may be damaged, the airway may be blocked by mucus, and clinical signs of hypoxia will appear. Therefore, to improve people's hypoxia and keep the airway open, the mucus must be diluted or dissolved. Actually these drugs have been used, but you can try again.

In clinical treatment, if the mucus components are not resolved, simply using oxygen supply may not achieve the purpose, and sometimes it will have adverse effects. The positive pressure of oxygen may push the mucus deeper and wider, which will increase the patient's hypoxia. It may be paying attention to this clinically, but we feel we still need to emphasize this issue.

Similar to SARS lesions

Beiqing Daily: Is it possible to clarify the transmission mechanism of New Coronavirus through pathological testing?

Liu Liang: The route of transmission of the virus is not a pathological problem. We did nucleic acid tests of different organs and tissues during the autopsy of the previous cases. Some of them were found. These problems need further analysis because different cases do The results are not very consistent.

Beiqing Daily: Some scholars have previously suggested that myocarditis or heartbreak syndrome may occur in some severely ill patients. Through anatomy, is this possible?

Liu Liang: The issue of an outbreak of myocarditis is still to be determined and needs to be discussed. Heartbreak syndrome is, I think, less likely.

Beiqing Newspaper: Related studies have shown that the homology between the new crown virus and SARS is very high. Through the anatomy of the remains, is it found that the lung manifestations of new crown pneumonia and SARS are significantly different? what's the difference?

Liu Liang: New coronary pneumonia is similar to SARS lesions, but also has its own characteristics. We will do some interpretation later.

Beiqing Daily: What difficulties do you face in your current work?

Liu Liang: It is very important for autopsy personnel to perform anatomical protection. The anatomical environment is equivalent to going to the place with the highest radiation concentration. So far, the protective materials have all come from other places. I hope more people will pay attention to our "special forces."

Text / Reporter Han Qian Wei Xiaohan

Coordinator / Shi Aihua Song Jianhua