“Is it true that coronavirus primarily affects the lungs?”

- Not always. The lungs are affected, as with the flu - only in severe cases of the disease. The disease proceeds in its own way, it has its own pathogenesis and points of influence. This is a new infection; we cannot reliably say which type of course is “normal” for it. We are just studying it.

For this group of viruses, it is primarily alveolar damage that is characteristic. In the lung alveoli, which are responsible for oxygen saturation of the body, the so-called hyaline membranes are formed - partitions that interfere with normal gas exchange, and the alveoli themselves are filled with protein fibrin and edematous fluid.

- It turns out that a patient with a severe form of coronavirus takes a breath, but does not breathe properly?

- Yes exactly. Blood is not saturated with oxygen, and all other organs also lack it. The brain most sensitive to oxygen deficiency. A person may lose consciousness, and respiratory failure may increase. With serious lung lesions - a severe acute respiratory syndrome - it is no longer necessary to have ventilators, but methods of extracorporeal oxygenation, which require direct access to large blood vessels.

  • Pathologist Darya Sitovskaya
  • © Photo from the personal archive

- Do pathologists already have special rules for working with this virus?

- COVID-19 was defined as a microorganism related to especially dangerous (quarantine) infections, such as plague, cholera, anthrax, tularemia, smallpox, yellow fever. In St. Petersburg, the majority of patients with COVID-19 are in a specialized infectious diseases hospital. Autopsies of coronavirus deceased should be carried out in antiplague suits, which are then disposed of, and the room is decontaminated with a chlorine-containing antiseptic.

- Visually, the lungs of a deceased person from COVID-19 are very different from healthy ones?

- I have not personally examined the lungs of such a patient, but my colleagues sent photos from autopsies for general familiarization. So that doctors understand what they are dealing with. Judging by the pictures and descriptions, the lungs of the deceased are dense, dark red, airless, but there is no pronounced edema. I suppose that they are similar in density to rubber in density. Healthy lungs are more like a soft and elastic dishwashing sponge. It should be noted that the reversibility of changes depends on the age and capabilities of a particular organism. The more concomitant pathologies (chronic obstructive pulmonary disease, emphysema, chronic bronchitis, bronchial asthma) - the more severe damage to the lung tissue.

- Is coronavirus the cause of death?

- So far, there is no clear statistics - fortunately, there is a small mortality rate in our country. In general, pathologists distinguish three causes of death: the main, immediate and immediate. The main one is COVID-19. The remaining two are concomitant diseases. Complications of somatic diseases (for example, myocardial infarction) are more common, that is, the deceased patient had diseases that could kill him at any time. And the virus could only accelerate the disease, because such an infection is a huge stress for the body.

Coronavirus spread

Recall that the COVID-19 flash was first recorded in the Chinese city of Wuhan at the end of December 2019. On March 11, the World Health Organization announced the coronavirus pandemic.

According to the Rospotrebnadzor of the Russian Federation, as of April 4, a total of more than 1 million people had the disease confirmed.

According to Johns Hopkins University, the first place in the world in the number of cases is taken by the United States, more than 330 thousand cases of infection are detected there. In Europe, Spain (over 135 thousand cases) became the leader in the number of infected people, followed by Italy (about 128 thousand cases), Germany (over 100 thousand) and France (almost 93 thousand).

In Russia, Rospotrebnadzor recorded 6343 cases of coronavirus in 80 regions. The number of deaths is 47.

In total, over 70 thousand infected died in the world.