PATHOHISTOLOGICAL CHANGES IN PATIENTS’ KIDNEYS WHO DIED FROM CORONAVIRUS DISEASE

Abstract

Acute kidney injury is one of the most severe complications, which leads to an increase in hospital mortality due to coronavirus disease. The mechanisms of its occurrence and changes in kidney tissues, which are the pathomorphological basis of kidney damage, require in-depth research. Objective. To identify and compare the pathohistological characteristics of the kidneys of deceased patients diagnosed with COVID-19 with and without TsD2. Material and methods. We analyzed 70 protocols of pathological and anatomical studies of patients who died in hospital due to severe course of coronavirus disease with lung damage. Autopsies followed by pathohistological examination were carried out on the basis of the Pathology Department of the Lviv Regional Clinical Hospital and the City Pathology Center 1 TMO of Lviv. Kidney samples were fixed, dehydrated and pouredinto a paraffin block. The findings were described using direct light microscopy. Two staining techniques were used (hematoxylin and eosin, Masson trichrome) using the Leica DM500 microscope and the Leica ICC50E chamber. Results. Among deceased patients with type 2 diabetes, subtotal tubular necrosis (51.6 % vs. 25.6 %, p = 0.03), neutrophil (16.1 % vs. 2.6 %, p = 0.04) and mononuclear (35.3 % vs. 2.8%, p = 0.03) infiltration of interstitium were significantly more common. Whereas in histological kidney samples of patients without diabetes, arteriosclerosis, hyaline and hydropic tubuledystrophy were more often observed. Glomerulosclerosis as a sign of chronic damage and a consequence of background diseases was observed in both groups. Conclusions. There is reason to believe that histopathological manifestations associated with acute tubular injury are the main results of kidney autopsy of patients with coronavirus disease, while glomerulosclerosis, arteriosclerosis and tubular dystrophies indicate the presence of background cardiovascular diseases.