Hallazgos macroscópicos y microscópicos en el sistema respiratorio en autopsias de pacientes con covid-19.
Macroscopic and microscopic findings in the respiratory system in patients with covid-19.
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Introducción: desde finales del 2019, el mundo se ha visto hostigado por la aparición de un nuevo coronavirus (SARS-CoV-2) en Wuhan, China, que se extendió globalmente y es el agente etiológico de la enfermedad conocida como COVID-19. Esta enfermedad tiene tres etapas consecutivas de gravedad y está asociada con el desarrollo del síndrome de dificultad respiratoria aguda (SDRA). Objetivo: describir las principales lesiones pulmonares, macroscópicas y microscópicas, asociadas con la infección por SARS-CoV-2, con base en hallazgos de autopsias realizadas a pacientes fallecidos por Covid-19. Métodos: se realizó una búsqueda en las bases de datos PubMed, Google Scholar, Scielo, Clinical Key y MedRxiv que incluyó artículos publicados entre el 1 de enero del 2020 y el 31 de diciembre de 2020. Resultados: el principal hallazgo macroscópico descrito fue la presencia de pulmones pesados además de superficies con áreas azul-rojizas. Se encontró en algunos casos traqueo-bronquitis y tráqueas levemente eritematosas. En hallazgos microscópicos el patrón de lesión pulmonar más común fue el daño alveolar difuso (DAD) presentado en el 88% de los casos. Se encontraron cambios en los capilares constituyendo 3 características histológicas: Lesión endotelial, alteración de las membranas de células endoteliales y angiogénesis intususceptiva. Conclusión: la gravedad de los hallazgos está determinada por la edad del paciente y el padecimiento de diversas comorbilidades/afecciones sobre todo relacionadas con el sistema respiratorio y cardiovascular, estos factores influyen en el desarrollo de hallazgos heterogéneos tanto macroscópicos como microscópicos.
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