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Lung damage in SARS-CoV-2 patients: An autopsy study in the era of vaccination.

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  • Additional Information
    • Source:
      Publisher: Wiley Country of Publication: England NLM ID: 0245331 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2362 (Electronic) Linking ISSN: 00142972 NLM ISO Abbreviation: Eur J Clin Invest Subsets: MEDLINE
    • Publication Information:
      Publication: Oxford : Wiley
      Original Publication: Berlin, New York, Springer-Verlag, on behalf of the European Society for Clinical Investigation.
    • Subject Terms:
      COVID-19*/prevention & control ; COVID-19*/mortality ; COVID-19 Vaccines*/therapeutic use ; Autopsy* ; Lung*/pathology ; Hospital Mortality*; Humans ; Male ; Female ; Aged ; Middle Aged ; Aged, 80 and over ; SARS-CoV-2 ; Vaccination ; Italy/epidemiology ; Cause of Death ; Adult ; Lung Injury
    • Abstract:
      Aims: The contribution of SARS-CoV-2 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.
      Methods: Post-mortem analysis was performed among consecutive in-patients with COVID-19 deceased in the Province of Trieste (2020-2022). The outcomes of the study were (i) rates of in-hospital mortality, (ii) contribution of COVID-19 to death, (iii) histological extent of lung injury and (iv) impact of vaccination.
      Results: A total of 1038 consecutive hospitalized patients who died with SARS-CoV-2 infection were autopsied and deep histological analysis of the lungs was performed in a randomly selected sample of 508 cases. Among them, SARS-CoV-2 infection was (a) the cause of death (n = 90), (b) contributing to death (n = 304) and (c) an accompanying feature (n = 114). The incidence of SARS-CoV-2 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-CoV-2 infection (HR .15, p < .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-vaccinated, 7% double-vaccinated. 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%, p < .001, respectively), and a substantially lower proportion of pneumonia severity score 3 (26.2% vs. 55.1%, p < .001) compared to unvaccinated patients.
      Conclusions: COVID-19 vaccination has substantially reduced rates of death related to SARS-CoV-2 infection over time and may have the ability to mitigate lung damage.
      (© 2024 The Author(s). European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.)
    • Comments:
      Erratum in: Eur J Clin Invest. 2025 Mar 25:e70037. doi: 10.1111/eci.70037.. (PMID: 40129350)
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    • Contributed Indexing:
      Keywords: COVID‐19; SARS‐CoV‐2; mortality; post‐mortem analysis; vaccination
    • Accession Number:
      0 (COVID-19 Vaccines)
    • Publication Date:
      Date Created: 20240930 Date Completed: 20241209 Latest Revision: 20250325
    • Publication Date:
      20250325
    • Accession Number:
      PMC11628649
    • Accession Number:
      10.1111/eci.14325
    • Accession Number:
      39344023