{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T07:29:16Z","timestamp":1767166156216,"version":"build-2238731810"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T00:00:00Z","timestamp":1727568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The contribution of SARS\u2010CoV\u20102 infection on lung damage and the effect of vaccination on either containing the number of deaths or mitigating lung damage has not been systematically investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Post\u2010mortem analysis was performed among consecutive in\u2010patients with COVID\u201019 deceased in the Province of Trieste (2020\u20132022). The outcomes of the study were (i) rates of in\u2010hospital mortality, (ii) contribution of COVID\u201019 to death, (iii) histological extent of lung injury and (iv) impact of vaccination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1038 consecutive hospitalized patients who died with SARS\u2010CoV\u20102 infection were autopsied and deep histological analysis of the lungs was performed in a randomly selected sample of 508 cases. Among them, SARS\u2010CoV\u20102 infection was (a) the cause of death (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200990), (b) contributing to death (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009304) and (c) an accompanying feature (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009114). The incidence of SARS\u2010CoV\u20102 infection as the primary cause of mortality decreased over time (23.8% in 2020, 20.9% in 2021 and 7.9% in 2022). On multivariable analysis, vaccination (any dose) was independently associated with lower rates of death related to SARS\u2010CoV\u20102 infection (HR .15,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), after adjusting for other independent predictors. A total of 172 patients were vaccinated at least with two doses at the time of death: 93% triple\u2010vaccinated, 7% double\u2010vaccinated. On histological analysis, vaccinated patients had a greater frequency of pneumonia severity score 0 and 1 (20.3% vs. 5.4% and 20.9% vs. 7.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001, respectively), and a substantially lower proportion of pneumonia severity score 3 (26.2% vs. 55.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) compared to unvaccinated patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>COVID\u201019 vaccination has substantially reduced rates of death related to SARS\u2010CoV\u20102 infection over time and may have the ability to mitigate lung damage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eci.14325","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:14:15Z","timestamp":1727655255000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lung damage in\n                    <scp>SARS<\/scp>\n                    \u2010\n                    <scp>CoV<\/scp>\n                    \u20102 patients: An autopsy study in the era of vaccination"],"prefix":"10.1111","volume":"55","author":[{"given":"Rossana","family":"Bussani","sequence":"first","affiliation":[{"name":"Institute of Pathological Anatomy and Histology, Azienda Sanitaria Universitaria Giuliano\u2010Isontina University of Trieste  Trieste Italy"},{"name":"Department of Medical, Surgical and Health Sciences University of Trieste  Trieste Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3307-0825","authenticated-orcid":false,"given":"Aldostefano","family":"Porcari","sequence":"additional","affiliation":[{"name":"Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano\u2010Isontina (ASUGI) University of Trieste  Trieste Italy"},{"name":"European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart\u2010ERN GUARD\u2010Heart  Trieste Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Pinamonti","sequence":"additional","affiliation":[{"name":"Institute of Pathological Anatomy and Histology, Azienda Sanitaria Universitaria Giuliano\u2010Isontina University of Trieste  Trieste Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthea","family":"Iacobucci","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Health Sciences University of Trieste  Trieste Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Belladonna","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Health Sciences University of Trieste  Trieste Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariella","family":"Tomasini","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Health Sciences University of Trieste  Trieste Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Zanconati","sequence":"additional","affiliation":[{"name":"Institute of Pathological Anatomy and Histology, Azienda Sanitaria Universitaria Giuliano\u2010Isontina University of Trieste  Trieste Italy"},{"name":"Department of Medical, Surgical and Health Sciences University of Trieste  Trieste Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Collesi","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Health Sciences University of Trieste  Trieste Italy"},{"name":"International Centre for Genetic Engineering and Biotechnology (ICGEB)  Trieste Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Giacca","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Health Sciences University of Trieste  Trieste Italy"},{"name":"International Centre for Genetic Engineering and Biotechnology (ICGEB)  Trieste Italy"},{"name":"School of Cardiovascular Medicine &amp; Sciences King's College London, British Heart Foundation Centre of Research Excellence  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Berlot","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Health Sciences University of Trieste  Trieste Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianfranco","family":"Sinagra","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Health Sciences University of Trieste  Trieste Italy"},{"name":"Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano\u2010Isontina (ASUGI) University of Trieste  Trieste Italy"},{"name":"European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart\u2010ERN GUARD\u2010Heart  Trieste Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Furio","family":"Silvestri","sequence":"additional","affiliation":[{"name":"Institute of Pathological Anatomy and Histology, Azienda Sanitaria Universitaria Giuliano\u2010Isontina University of Trieste  Trieste Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-02156-9"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.2648"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2015432"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41421-021-00249-2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.701278"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad040"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2110475"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2034577"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2021.08.018"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-022-07418-y"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2020.103104"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-021-01910-2"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.6035"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(23)00079-8"},{"issue":"9","key":"e_1_2_10_16_1","first-page":"714","article-title":"Estimated number of lives directly saved by COVID\u201019 vaccination programs in the WHO European region, December 2020 to march 2023","volume":"12","author":"Mesl\u00e9 MMI","year":"2024","journal-title":"medRxiv"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)02467-4"},{"issue":"2","key":"e_1_2_10_18_1","first-page":"551","article-title":"Autopsies revealed pathological features of COVID\u201019 in unvaccinated vs vaccinated patients","volume":"11","author":"Colombo D","year":"2023","journal-title":"Biomedicine"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.14931"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102683"}],"updated-by":[{"DOI":"10.1111\/eci.70037","type":"erratum","label":"Erratum","source":"publisher","updated":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000}}],"container-title":["European Journal of Clinical Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.14325","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T23:37:54Z","timestamp":1733787474000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/eci.14325"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,29]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1111\/eci.14325"],"URL":"https:\/\/doi.org\/10.1111\/eci.14325","archive":["Portico"],"relation":{},"ISSN":["0014-2972","1365-2362"],"issn-type":[{"value":"0014-2972","type":"print"},{"value":"1365-2362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,29]]},"assertion":[{"value":"2024-07-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14325"}}