ECP 2023 Abstracts

S125 Virchows Archiv (2023) 483 (Suppl 1):S1–S391 13 between the initial and later waves. Bacterial over-infection with viral pneumonia was more prevalent in both cancer and non-cancer patients in the later waves of pandemic (p=0.04/p<0.0001). Conclusion: In cancer patients, the course of COVID-19 was much more balanced during the pandemic than in non-cancer patients, who more often had severe, fatal COVID-19 in the early disease waves. This may be partly due to the relative immunosuppressed status of cancer patients, and to the fact that even early/mild viral infection can more easily upset the balance of their condition, leading to death from their underlying cancer or its other complications. Funding: K_22 142604 grant of the National Research, Development and Innovation Office (Hungary) PS-21-006 Expression of calpain 10 in different mechanisms of heart cell death K. Matušan Ilijaš*, I. Medved, A. Ferenčić, S. Arbanas, L. Kunišek *Clinical Hospital Center Rijeka, Croatia Background & objectives: Calpains are cellular proteins involved in different diseases with potentially prophylactic and therapeutic impli- cations. The aim of the study was to analyse calpain 10 expression in heart cells during ischemia, infarction, apoptosis, hyperglycaemia and death by head gunshot. Methods: Using immunohistochemistry calpain 10 expression was analysed on 205 heart tissue samples taken during forensic autopsies in the case of sudden cardiac death (SCD) caused by myocardial ischemia or infarction in diabetic (D) and non-diabetic (ND) patients as well as in the case of head gunshot. TUNEL method was used to determine the degree of apoptosis. Results: Cardiomyocytes calpain 10 expression was higher in non- ischemic than in ischemic/infarction region of SCD group (P<0.001) with negative correlation to degree of cardiomyocytes apoptosis (rs=- 0.593; P<0.001) in D as well as ND group. The calpain 10 expression was also significantly higher in D than in ND group as well as in head gunshot group (P<0.001) than in SCD group (P<0.001). Among other heart cells, only endothelial cells showed similar results as cardio- myocytes in comparison of non-ischemic region to ischemic/infarction region of SCD group (P<0.001). On the contrary, non-cardiomyocytes followed the results of cardiomyocytes when D and ND group was compared at the statistically significant level. Conclusion: Calpain 10 upregulation in SCD and death by head gun- shot but also diabetes mellitus could be explained by its protective role preventing programmed cell death during homeostasis dysregulation. This is particularly important in the case of cardiomyocytes, but similar results for endothelial cells prove their important role in tissue mainte- nance through its regeneration. Calpain 10 upregulation in cardiomyo- cytes as well non-cardiomyocytes in patients with diabetes mellitus con- firms previously well-established molecular background of this disease. PS-21-007 Autopsy findings and thromboembolic complications in patients died with COVID-19 T. Muzashvili*, B. Märkl, P. Adam *Pathology, Faculty of Medicine, University of Augsburg, Germany Background & objectives: The symptomology of patients infected with the novel coronavirus disease (SARS-CoV-2 caused COVID-19) shows a great variability. After clinical observations and autopsy find- ings, it became clear that the disease causes acute respiratory distress syndrome (ARDS) including angiopathy, endotheliitis and thrombosis. Methods: We have analysed 148 autopsy cases of patients died with COVID-19 infection with a main focus on thromboembolism of central or peripheral lung arteries. Additionally, the presence of associated acute myocardial and cerebral infarcts was investigated. Furthermore, we analysed the application of invasive mechanical ventilation and its correlation with thromboembolic complications. Results: We compared our findings with a control group (CG-1 ) of four patients died with respiratory syncytial virus (RSV) pneumonia, 11 patients died with influenza virus and a group of 29 patients with proven SARS-CoV-2 infection but a cause of death which was not related to COVID-19 (CG-2). All statistical tests were performed using SPSS software. Autopsy revealed central lung arterial thrombosis in 8 of 148 patients (5%); peripheral lung artery thromboembolism was seen in 23/148 cases (16%); acute myocardial infarct was detected in 7 (5%) und acute cerebral infarct in 2 cases (1%). In CG-2 we did not find any events of thromboembolism or acute myocardial or cerebral infarct. Conclusion: In contrast to many previous reports we identified in this large study pulmonary thromboembolic events in a low frequency in fatal cases of COVID-19. Further investigations are currently underway to investigate the occurrence of capillary fibrin thrombi. PS-21-008 Evolving patterns of drug and alcohol toxicity; a single-institution review D. O’Connor*, C. Mulvey, E. O’Connor, K. O’Hare *Coombe Hospital, Ireland Background & objectives: The use of toxicology as a key ancillary investigation in autopsy practise is of essential importance. The aim was to analyse the patterns of lethal drug and alcohol toxicity at our autopsy practise to assess the importance of toxicological analysis. Methods: All autopsy reports at our institution between 2018 and 2021 were analysed. The cause of death and the presence of positive toxicol- ogy was recorded. Lethal overdoses of non-illicit drugs such as par- acetamol were excluded. For any toxicological result that contributed to death, the exact agent was documents. Results: 599 autopsy reports were analysed. Of these, the cause of death was directly related to lethal drug and/or alcohol toxicity in 12% of cases (n=72). 57.5% (n=23) of drug and alcohol toxicity cases were related to multidrug toxicity. In 22.2% (n=16) of drug and alcohol toxicity cases, a single drug or class of drug present within the lethal range resulted in death. Of these, 81.2% (n=13) were due to opiates, including oxycodone, heroin and methadone. Alcohol toxicity alone was fatal in 9.7% (n=7) of cases, with alcohol and benzodiazepine toxicity combined fatal in 2.7 % (n=2) of cases. Conclusion: 12% of autopsies at our institution had a cause of death directly related to lethal drug and alcohol overdoses. The majority of single drug overdoses were due to opiates. Autopsy practise is con- stantly evolving, with the use of ancillary investigations paramount to successfully identifying the causes of death in many situations. Our study highlights the role of toxicology as an essential investigation and details the evolving patterns of drug and alcohol toxicities in our population. PS-22 | Poster Session Cardiovascular Pathology PS-22-002 Calcified aortic valve disease (CAVD) in autopsy cases S. Glumac, R. Janković*, J. Varda, M. Jovanović *Institute for Pathology, Medical Faculty, University of Belgrade, Serbia Background & objectives: The calcifications in CAVD represents actively produced osteoid matrix by osteiod producing cells in response to inflammatory milieu. The origin of those cells is still unclear; they are either activated valvular interstitial cells (VICs), or transformed macrophages with osteoblast-like features.