ECP 2022 Abstract Book

Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 Conclusion: COVID-19 associated mucormycosis is most likely under- diagnosed. As our experience confirms, rapid initiation of both aggres- sive surgical debridement and antifungal therapy is vital in providing patients with better outcomes. In order to facilitate early treatment, a timely diagnosis is of utmost importance. A high index of suspicion is required in the face of patients with a history of COVID-19 present- ing with sinusitis, proptosis or other craniofacial signs and symptoms. E-PS-13-004 Clinico-morphological peculiarities in cases of COVID- 19 infection combined with diabetes mellitus A. Voronina*, O. Reshetnikova, A. Ermakov, L. Rudiuk, S. Morozov *Immanuel Kant Baltic Federal University, Russia Background & objectives: Diabetes mellitus(DM) as an underlying disease in cases of COVID-19 is associated with severe cause of infec- tion and increased mortality. The aim of present study was to investi- gate organs’ damages induced by COVID-19 infection in patients with diabetes mellitus co-morbidity. Methods: Post-mortem examinations were performed in 34 lethal cases of COVID-19 infection with DM co-morbidity. Patients’ medical records were evaluated. The group included 16 males and 18 females, 49 - 90 y.o. Hospitalization’s duration was 1-39 days. Macroscopic examinations of the internal organs performed. Tissue samples were taken for histology. Microscopy of H&E stained slides done at x10, x20, x40. Results: Autopsy has shown multi-organ damages in all cases. Diabetes – induced angiopathies were registered in 9, polyneuropathies - in 8, retinopathies - in 6 and nephropathies- in 10 cases. Diffuse lungs alveolar damage revealed in all patients. Histologically were found microangiopathies, perivascular, intrabronchiolar and intraalveolar haemorrhages interspersed with areas of alveoli filled by oedematous fluid. Vessels with erythrocyte sludge, fibrin and thrombi were recognized. Desquamation of the alveolar and bronchiolar epithelium cells were often replaced by hyaline membranes. Interalveolar septi were thickened due to vessels congestion, oedema, inflammatory infiltrations and haemorrhages. Myocardium, liver, kidneys were characterized by hypoxic and metabolic damage of various sizes accompanied with local microangiopathies and petechial haemorrhages. Conclusion: The study has shown that diabetes mellitus as a comorbidity was the important risk factors for COVID-19 patients. Multiple organ dysfunctions due to diffuse structural injuries in lungs and other organs caused by the severe COVID-19 and affected by underlying diabetes mellitus was a prerequisite for the lethal outcome of the disease. Further studies of the pulmonary, blood vessels and parenchymal organs dysfunction’ mechanisms may help designing effective clinical management of infected patients with diabetes comorbidity. E-PS-13-005 Morphological characteristics of kidneys damage induced by SARS-COV-2 O. Reshetnikova*, A. Ermakov, L. Rudiuk, S. Morozov *Immanuel Kant Baltic Federal University, Russia Background & objectives: Infection with SARS-CoV-2 can not only cause respiratory system pathology but also result in multiple organs insufficiency. The aim of present study was to reveal structural peculi- arities of kidneys damage in fatal cases of the COVID-19. Methods: A full pathological post-mortem examinations were performed in 60 fatal cases of the SARS-COV-2. All clinical data were studied. Gross pathology of the lungs, kidneys, other internal organs and brain were examined. Tissue samples were taken for histology. Microscopy of H&E stained slides performed at x10, x20, x40. Kidneys pathology features were recorded and analysed. Results: This study has shown the kidneys structural injuries pre- sented with areas of dystrophy and necrosis in the epithelium of the convoluted tubules, various glomerulopathies in patients with COVID-19 infection. Morphological manifestations of mesangial glomerulonephritis occurred in many cases. Quite often in glo- meruli fibrinoid necrosis of capillary loops was noted. Sclerotic changes in glomeruli, including focal and diffuse, were often detected in kidneys’ tissue. There were also found ischemic infarc- tions as a result of SARS-COV-2 induced vascular thrombosis. Tubulo-interstitial pathology with stromal oedema and inflam- matory infiltrates revealed in many cases. Features of pulmonary pathology, including atypical interstitial bilateral pneumonia, dif- fuse alveolar damage and hyaline membranes formation supported the COVID-19 diagnosis. Conclusion: SARS-COV-2 infection has become a global health crisis, responsible for the significant growth of patient’s morbidity and mortality worldwide. Post-mortem examination is an essential tool in understanding multi-organ pathology in this novel infection. The results have shown renal tropism along with severe respiratory distress syndrome. Kidneys tissues damages, inflammatory reac- tions, blood circulation disturbances significantly contributed to organ’s insufficiency and fatal outcomes. Further investigations of kidneys affection as one of important SARS-COV-2’ targets are considered essential. E-PS-13-006 Lethal case of schizophrenia with generalized chlamydia infection V. Zinserling*, N. Lugovskaya, N. Semenova *V.A. Almazov Research Center, Russia Background & objectives: Schizophrenia remains very important disease with unclear aetiology. Among other theories infectious has many arguments, but direct detection of chlamydia antigen in brain has been never reported. Methods: Lethal case of woman N.E., 37 ys. Nearby routine path- ological examination has been done PAS reaction and immuno- histochemistry including sera against Chlamydia trachomatis and Toxoplasma gondii. Results: Patient suffered from paranoid form of schizophrenia for several years. Deterioration was due to coronavirus infection, confirmed at the autopsy. Additionally, was detected pseudomembranous colitis. Special attention was paid to changes of macrophages, nervous and epithelial cells in lungs, brain, kidneys, liver, spleen with multiple small vesicles. In all organs were detected extra- and intracellular PAS-positive inclusions. IHC investigation has been done. Chlamydia antigen was clearly detected in all internal organs. Special attention was paid to the brain, where positive reaction was noted in the cytoplasm of nervous cells and in white matter as well. IHC with serum against toxoplasma gave no distinct positive reaction. Conclusion: Thus, our case strongly supports the infectious con- cept of schizophrenia although further studies including additional cases and methods are necessary. S294