Clinico-pathological features in fatal COVID-19 infection: a preliminary experience of a tertiary care center in North India using postmortem minimally invasive tissue sampling

  1. Animesh Ray
  2. Deepali Jain
  3. Ayush Goel
  4. Shubham Agarwal
  5. Shekhar Swaroop
  6. Prasenjit Das
  7. Sudheer Kumar Arava
  8. Asit Ranjan Mridha
  9. Aruna Nambirajan
  10. Geetika Singh
  11. S. Arulselvi
  12. Purva Mathur
  13. Sanchit Kumar
  14. Shubham Sahni
  15. Jagbir Nehra
  16. Nazneen
  17. Mouna Bm
  18. Neha Rastogi
  19. Sandeep Mahato
  20. Chaavi Gupta
  21. S Bharadhan
  22. Gaurav Dhital
  23. Pawan Goel
  24. Praful Pandey
  25. Santosh Kn
  26. Shitij Chaudhary
  27. Vishakh C Keri
  28. Vishal Singh Chauhan
  29. Niranjan Mahishi
  30. Anand Shahi
  31. Ragu R
  32. Baidnath K Gupta
  33. Richa Aggarwal
  34. Kapil Dev Soni
  35. Neeraj Nischal
  36. Manish Soneja
  37. Sanjeev Lalwani
  38. Chitra Sarkar
  39. Randeep Guleria
  40. Naveet Wig
  41. Anjan Trikha

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Abstract

No abstract available

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  1. Version published to 10.1080/17476348.2021.1951708
  2. ScreenIT

    SciScore for 10.1101/2020.11.12.20229658: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Ethical consent for post-mortem tissue sampling was obtained from the next of kin as per institutional guidelines.
    IRB: The study was approved by the Institute Ethics Committee (Ref No: IEC-536/05.06.2020).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Immunohistochemistry for CD163 (MA5-11458, Invitrogen, 1:200) and CD61 (MA1-80862, Invitrogen, 1:50) was performed in all lung cores, while SARS-CoV-2 virus was detected by immunohistochemistry using primary antibodies directed against SARS nucleoprotein (B46F clone, Invitrogen, Catalog # MA1-7404, 1:400), in selected lung samples.
    CD163
    suggested: (Thermo Fisher Scientific Cat# MA5-11458, RRID:AB_10982556)
    CD61
    suggested: None
    SARS
    suggested: (Antibodies-Online Cat# ABIN236332, RRID:AB_10771459)
    B46F
    suggested: (Thermo Fisher Scientific Cat# MA1-7404, RRID:AB_1018422)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    In this cohort, we identified substantial histological changes of hepatocyte necrosis, degeneration, Kupffer cell hypertrophy, micro, and macrovesicular steatosis, more than the vascular changes.(21) The relative paucity of inflammation in the liver may be related to the treatment regimen or the inherited limitations of sampling by biopsies. Our histological findings match with those described by Lagana SM et al. except the fibrin ring granulomas the authors identified in 3 of their cases out of 40 liver biopsies examined(22). Out of the 8 liver biopsies which showed acute hepatic necrosis in our series, macrovescular steatosis was identified in 3 (37.5%) and microvescular steatosis was noted in another 3 biopsies (37.5%) [Supplementary Table 1]. A report from China on 300 fatal Covid-19 cases, it was found that steatosis and high neutrophil to lymphocyte ratio were the indicators of clinical aggressivenes.(23) This needs further elucidation. Except for paucity of the bile duct in one of our cases, the bile duct pathologies were not prominent in our cases, supporting the observation of Tian S. et al(4). Renal histopathology in COVID-19 is reported to show changes including prominently acute tubular injury (more prominent in the proximal tubules)(18,24–28), arteriosclerosis (18) or glomerulosclerosis (29) (both as features of underlying comorbid conditions like hypertension), focal segmental glomerulosclerosis with a collapsing phenotype (25–27) and tubulointerstitial inflamma...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.11.12.20229658v1 on medRxiv