THE EXPERIENCE OF CLINICAL AND MORPHOLOGICAL ANALYSIS OF FATAL CASES OF CORONAVIRUS INFECTION OF THE "FIRST WAVE" (SPRING-AUTUMN 2020)
Introduction. The study of pathomorphogenesis and thanatogenesis in a COVID-19 became in the period 2020-2021 new professional challenge for the pathological service. This determined the main direction of diagnostic and research activities during this period.Aim: clinical and morphological analysis of deaths and to summarize the experience gained from the study of deceased patients who died from severe forms of new coronavirus infection, who were hospitalized in the rst wave of the pandemic.Materials and methods. The study included clinical and morphological data obtained from the study of medical records and cadavers of 100 patients with intravital and (or) postmortem con rmed new coronavirus infection.Results and discussion. It was found that the largest proportion of the dead belongs to the elderly (60-74 years old) and senile (75- 90 years old) age groups - 38% and 43%, respectively; deceased young age - 2.During hospitalization, half of them had high-grade lung lesions: CT-3 and CT-4 - in 31.1% and 28.5%, respectively. In other cases, lung damage progressed in the hospital. The paper provides data on the average length of hospitalization, comorbidity, averaged indicators of clinical and biochemical blood tests. It was found that the main mechanism of thanatogenesis was pulmonary (79%), associated with an increase in respiratory failure or ARDS; in 19% of the deceased, the cardiac mechanism of death was revealed; in 2% of cases, the cause of death was general intoxication. Pathogistologically, in the lungs of the deceased, signs of various phases of di use alveolar damage were revealed, and in patients who had been in hospital for a long time, increasing pulmonary brosis and pathological regeneration of the respiratory epithelium were found. The result of immunohistochemical detection of the N-protein of the SARS-Cov-2 virus has been demonstrated.Conclusion. The study revealed clinical and morphological relationships in patients with severe forms of coronavirus infection, established a thanatological pro le