{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T14:15:06Z","timestamp":1765808106742,"version":"build-2065373602"},"reference-count":42,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T00:00:00Z","timestamp":1664409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>We report the case of a 34-year-old male patient, a bodybuilding trainer and user of anabolic androgenic steroids (AASs) for 16 years. He was found in cardio-respiratory arrest in his home. By performing a medico-legal autopsy, a severe form of COVID-19, aortic atherosclerotic plaques, and an old myocardial infarction was found. The SARS-CoV-2 RT-PCR test on necroptic lung fragments was positive, with a B.1.258 genetic line. The histopathological examinations showed microthrombi with endothelitis in the cerebral tissue, massive pulmonary edema, diffuse alveolar damage grade 1, pulmonary thromboembolism, hepatic peliosis, and severe nesidioblastosis. The immunohistochemical examinations showed SARS-CoV-2 positive in the myocardium, lung, kidneys, and pancreas. ACE-2 receptor was positive in the same organs, but also in the spleen and liver. HLA alleles A*03, A*25, B*18, B*35, C*04, C*12, DRB1*04, DRB1*15, DQB1*03, DQB1*06 were also identified. In conclusion, death was due to a genetic predisposition, a long-term abuse of AASs that favored the development of a pluriorganic pathological tissue terrain, and recent consumption of AASs, which influenced the immune system at the time of infection.<\/jats:p>","DOI":"10.3390\/medicina58101373","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T23:09:29Z","timestamp":1664492969000},"page":"1373","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Fatal Form of COVID-19 in a Young Male Bodybuilder Anabolic Steroid Using: The First Autopsied Case"],"prefix":"10.3390","volume":"58","author":[{"given":"Costel Vasile","family":"Siserman","sequence":"first","affiliation":[{"name":"Institute of Legal Medicine, 400006 Cluj-Napoca, Romania"},{"name":"Department of Legal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3465-9474","authenticated-orcid":false,"given":"Ionu\u021b Isaia","family":"Jeican","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Embryology, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"},{"name":"Infectious Disease Clinical Hospital, 400000 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Gheban","sequence":"additional","affiliation":[{"name":"Department of Pathology, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"},{"name":"Department of Pathology, Emergency Clinical Hospital for Children, 400370 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vlad","family":"Anton","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Mironescu","sequence":"additional","affiliation":[{"name":"Institute of Legal Medicine, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergiu","family":"\u0218u\u0219man","sequence":"additional","affiliation":[{"name":"Imogen Medical Research Institute, County Clinical Emergency Hospital, 400000 Cluj-Napoca, Romania"},{"name":"Department of Histology, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0811-0821","authenticated-orcid":false,"given":"Mihaela Laura","family":"Vic\u0103","sequence":"additional","affiliation":[{"name":"Institute of Legal Medicine, 400006 Cluj-Napoca, Romania"},{"name":"Department of Cell and Molecular Biology, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8226-6026","authenticated-orcid":false,"given":"Mihaela","family":"Laz\u0103r","sequence":"additional","affiliation":[{"name":"Viral Respiratory Infections Laboratory, Cantacuzino National Military-Medical Institute for Research and Development, 050096 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7051-3758","authenticated-orcid":false,"given":"Maria","family":"Alua\u0219","sequence":"additional","affiliation":[{"name":"Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, Victor Babe\u0219 Str., No. 15, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corneliu","family":"Toader","sequence":"additional","affiliation":[{"name":"Clinic of Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 041914 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2858-8470","authenticated-orcid":false,"given":"Silviu","family":"Albu","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery and Otorhinolaryngology, University Clinical Hospital of Railway Company, Iuliu Hatieganu University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1557988320966536","DOI":"10.1177\/1557988320966536","article-title":"Characteristics and Attitudes of Men Using Anabolic Androgenic Steroids (AAS): A Survey of 2385 Men","volume":"14","author":"Bonnecaze","year":"2020","journal-title":"Am. 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