{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:30:41Z","timestamp":1792110641606,"version":"4.4.0"},"reference-count":68,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Coronavirus disease (COVID-19) is the pandemic caused by SARS-CoV-2 that has caused more than 2.2 million deaths worldwide. We summarize the reported pathologic findings on biopsy and autopsy in patients with severe\/fatal COVID-19 and documented the presence and\/or effect of SARS-CoV-2 in all organs.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods and findings<\/jats:title>\n<jats:p>A systematic search of the PubMed, Embase, MedRxiv, Lilacs and Epistemonikos databases from January to August 2020 for all case reports and case series that reported histopathologic findings of COVID-19 infection at autopsy or tissue biopsy was performed. 603 COVID-19 cases from 75 of 451 screened studies met inclusion criteria. The most common pathologic findings were lungs: diffuse alveolar damage (DAD) (92%) and superimposed acute bronchopneumonia (27%); liver: hepatitis (21%), heart: myocarditis (11.4%). Vasculitis was common only in skin biopsies (25%). Microthrombi were described in the placenta (57.9%), lung (38%), kidney (20%), Central Nervous System (CNS) (18%), and gastrointestinal (GI) tract (2%). Injury of endothelial cells was common in the lung (18%) and heart (4%). Hemodynamic changes such as necrosis due to hypoxia\/hypoperfusion, edema and congestion were common in kidney (53%), liver (48%), CNS (31%) and GI tract (18%). SARS-CoV-2 viral particles were demonstrated within organ-specific cells in the trachea, lung, liver, large intestine, kidney, CNS either by electron microscopy, immunofluorescence, or immunohistochemistry. Additional tissues were positive by Polymerase Chain Reaction (PCR) tests only. The included studies were from numerous countries, some were not peer reviewed, and some studies were performed by subspecialists, resulting in variable and inconsistent reporting or over statement of the reported findings.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The main pathologic findings of severe\/fatal COVID-19 infection are DAD, changes related to coagulopathy and\/or hemodynamic compromise. In addition, according to the observed organ damage myocarditis may be associated with sequelae.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0250708","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T20:36:12Z","timestamp":1619642172000},"page":"e0250708","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":97,"title":["Pathological findings in organs and tissues of patients with COVID-19: A systematic 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Short version, v.2, 29 July 2020 [Internet]","year":"2020"},{"issue":"5","key":"pone.0250708.ref029","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1164\/ajrccm.152.5.7582287","article-title":"Prospective validation of an acute respiratory distress syndrome predictive score","volume":"152","author":"JE Heffner","year":"1995","journal-title":"American Journal of Respiratory and Critical Care Medicine"},{"key":"pone.0250708.ref030","volume-title":"COVID-19 Clinical management: living guidance","author":"Organization WH","year":"2021"},{"key":"pone.0250708.ref031","volume-title":"Ongoing Living Update of Potential COVID-19 Therapeutics Options: Summary of Evidence","author":"Organization PAH","year":"2021"},{"issue":"3","key":"pone.0250708.ref032","first-page":"485","article-title":"Causes of mortality in patients with the adult respiratory distress syndrome","volume":"132","author":"AB Montgomery","year":"1985","journal-title":"Am Rev Respir Dis"},{"issue":"12","key":"pone.0250708.ref033","article-title":"Lung transplantation as therapeutic option in acute respiratory distress syndrome for coronavirus disease 2019-related pulmonary fibrosis","volume":"133","author":"J-Y Chen","year":"2020","journal-title":"Chin Med J (Engl)"},{"key":"pone.0250708.ref034","article-title":"Epidemiology of Venous Thromboembolism in SARS- CoV-2 Infected Patients: A Systematic Review and Meta-Analysis","author":"S Maitra","year":"2020","journal-title":"medRxiv"},{"issue":"9","key":"pone.0250708.ref035","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1161\/CIRCRESAHA.116.306853","article-title":"Cross Talk Pathways Between Coagulation and Inflammation","volume":"118","author":"H Foley Jonathan","year":"2016","journal-title":"Circulation Research"},{"issue":"10234","key":"pone.0250708.ref036","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1016\/S0140-6736(20)30937-5","article-title":"Endothelial cell infection and endotheliitis in COVID-19","volume":"395","author":"Z Varga","year":"2020","journal-title":"The Lancet"},{"issue":"20","key":"pone.0250708.ref037","doi-asserted-by":"crossref","first-page":"2186","DOI":"10.1182\/blood-2018-10-862243","article-title":"Neutrophils: back in the thrombosis spotlight","volume":"133","author":"DF Noubouossie","year":"2019","journal-title":"Blood"},{"issue":"10","key":"pone.0250708.ref038","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1182\/blood.2020007008","article-title":"Neutrophil extracellular traps contribute to immunothrombosis in COVID-19 acute respiratory distress syndrome","volume":"136","author":"EA Middleton","year":"2020","journal-title":"Blood"},{"issue":"11","key":"pone.0250708.ref039","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1111\/jth.14578","article-title":"Diagnosis and management of sepsis-induced coagulopathy and disseminated intravascular coagulation","volume":"17","author":"T Iba","year":"2019","journal-title":"Journal of Thrombosis and Haemostasis"},{"issue":"9","key":"pone.0250708.ref040","doi-asserted-by":"crossref","first-page":"2118","DOI":"10.1111\/jth.14960","article-title":"Fibrinolysis and COVID-19: A plasmin paradox","volume":"18","author":"RL Medcalf","year":"2020","journal-title":"J Thromb Haemost"},{"issue":"6","key":"pone.0250708.ref041","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1111\/bjh.16749","article-title":"COVID19 coagulopathy in Caucasian patients","volume":"189","author":"H Fogarty","journal-title":"Br J Haematol"},{"issue":"2","key":"pone.0250708.ref042","doi-asserted-by":"crossref","first-page":"e55262","DOI":"10.1371\/journal.pone.0055262","article-title":"Nebulized fibrinolytic agents improve pulmonary fibrinolysis but not inflammation in rat models of direct and indirect acute lung injury","volume":"8","author":"JJ Hofstra","year":"2013","journal-title":"PLoS One"},{"issue":"5","key":"pone.0250708.ref043","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1111\/jth.14810","article-title":"ISTH interim guidance on recognition and management of coagulopathy in COVID-19","volume":"18","author":"J Thachil","year":"2020","journal-title":"J Thromb Haemost"},{"issue":"4","key":"pone.0250708.ref044","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.jvsv.2020.04.004","article-title":"Upsurge of deep venous thrombosis in patients affected by COVID-19: Preliminary data and possible explanations. Journal of Vascular Surgery","volume":"8","author":"EM Marone","year":"2020","journal-title":"Venous and Lymphatic Disorders"},{"issue":"8","key":"pone.0250708.ref045","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1111\/jth.14888","article-title":"Incidence of venous thromboembolism in hospitalized patients with COVID-19","volume":"18","author":"S Middeldorp","journal-title":"J Thromb Haemost"},{"key":"pone.0250708.ref046","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.thromres.2020.04.014","article-title":"Severe COVID-19 infection associated with endothelial activation","volume":"190","author":"R Escher","year":"2020","journal-title":"Thromb Res"},{"key":"pone.0250708.ref047","author":"National Institutes of Health USDoHHS","year":"2021","journal-title":"Full-dose blood thinners decreased need for life support and improved outcome in hospitalized COVID-19 patients"},{"issue":"4","key":"pone.0250708.ref048","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1007\/s11239-020-02245-x","article-title":"In vivo demonstration of microvascular thrombosis in severe COVID-19","volume":"50","author":"DA do Esp\u00edrito Santo","year":"2020","journal-title":"J Thromb Thrombolysis"},{"issue":"4","key":"pone.0250708.ref049","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.3201\/eid2704.204337","article-title":"Difficulties in Differentiating Coronaviruses from Subcellular Structures in Human Tissues by Electron Microscopy","volume":"27","author":"HA Bullock","journal-title":"Emerg Infect Dis"},{"key":"pone.0250708.ref050","article-title":"Pathophysiology of SARS-CoV-2: targeting of endothelial cells renders a complex disease with thrombotic microangiopathy and aberrant immune response","author":"C Bryce","year":"2020","journal-title":"The Mount Sinai COVID-19 autopsy experience. medRxiv"},{"key":"pone.0250708.ref051","author":"JH Medicine","year":"2020","journal-title":"Hemophagocytic Lymphohistiocystosis https:\/\/www.hopkinsmedicine.org\/health\/conditions-and-diseases\/hemophagocytic-lymphohistiocystosis: The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System"},{"issue":"2","key":"pone.0250708.ref052","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1111\/j.1939-1676.1991.tb00939.x","article-title":"The influence of corticosteroids on host defense mechanisms","volume":"5","author":"LA Cohn","year":"1991","journal-title":"J Vet Intern Med"},{"issue":"7408","key":"pone.0250708.ref053","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1038\/nature11228","article-title":"ACE2 links amino acid malnutrition to microbial ecology and intestinal inflammation","volume":"487","author":"T Hashimoto","year":"2012","journal-title":"Nature"},{"issue":"1","key":"pone.0250708.ref054","first-page":"495","article-title":"Unspecific post-mortem findings despite multiorgan viral spread in COVID-19 patients","volume":"24","author":"M Remmelink","journal-title":"Crit Care. 2020"},{"key":"pone.0250708.ref055","first-page":"1","volume-title":"Elsevier\u2019s Integrated Pathology","author":"TC King","year":"2007"},{"issue":"4","key":"pone.0250708.ref056","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.2353\/ajpath.2006.051296","article-title":"Systemic viral infections and collateral damage in the liver","volume":"168","author":"DH Adams","year":"2006","journal-title":"Am J Pathol"},{"issue":"10","key":"pone.0250708.ref057","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1056\/NEJMc2019373","article-title":"Neuropathological Features of Covid-19","volume":"383","author":"IH Solomon","year":"2020","journal-title":"N Engl J Med"},{"key":"pone.0250708.ref058","article-title":"Acute Endotheliitis (Type 3 Hypersensitivity Vasculitis) in Ten COVID-19 Autopsy Brains","author":"RH Rhodes","year":"2021","journal-title":"medRxiv"},{"issue":"6","key":"pone.0250708.ref059","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1001\/jama.2020.12603","article-title":"Persistent Symptoms in Patients After Acute COVID-19","volume":"324","author":"A Carf\u00ec","year":"2020","journal-title":"Jama"},{"key":"pone.0250708.ref060","first-page":"25","article-title":"Cerebral Micro-Structural Changes in COVID-19 Patients \u2013 An MRI-based 3-month Follow-up Study","author":"Y Lu","year":"2020","journal-title":"EClinicalMedicine"},{"issue":"10","key":"pone.0250708.ref061","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1161\/CIRCRESAHA.120.317015","article-title":"Angiotensin-Converting Enzyme 2: SARS-CoV-2 Receptor and Regulator of the Renin-Angiotensin System: Celebrating the 20th Anniversary of the Discovery of ACE2","volume":"126","author":"M Gheblawi","year":"2020","journal-title":"Circ Res"},{"key":"pone.0250708.ref062","article-title":"Human Kidney is a 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