The novel coronavirus pneumonia death death body autopsy general observation report (hereinafter referred to as the report) is published in the thirty-sixth volume first issue of the February 2020 issue of the Journal of forensic medicine. The writer is the president of the Hubei forensic Association and Professor Liu Liang, Professor of forensic medicine, Tongji Medical College of Huazhong University of Science and Technology.
The novel coronavirus pneumonia mainly causes deep inflammatory reaction of airway and alveolar injury. Pulmonary fibrosis and consolidation are not caused by SARS, but the exudative response is more obvious than SARS.
In novel coronavirus pneumonia, Liu Liang called for a pathological anatomic study of the new crown pneumonia victims in January 22nd and sent an emergency report to the relevant departments to emphasize the importance of pathological anatomy. Liu Liang believes that the novel coronavirus pneumonia dead body pathological anatomy, can provide strong support for clinical treatment and diagnosis.
After novel coronavirus pneumonia outbreaks, Liu Liangs team sent an emergency report to the Hubei provincial government, which stressed the importance and feasibility of autopsy and received a positive reply. Thirty years after the outbreak of the new crown pneumonia,
Novel coronavirus pneumonia was successfully completed novel coronavirus pneumonia in Wuhan at 3 a.m. on February 16th, and the first autopsies of the new crown pneumonia died in China. Novel coronavirus pneumonia was successfully completed in second hospitals at 18:45 PM. Liu Liangs team undertook the two dissection tasks.
Novel coronavirus pneumonia was released on February 16th at 23:12, Liu Liang, who made a detailed statement of 2 consecutive cases of new crown pneumonia within 18 hours of his death in his personal headline account, forensic Liu Liang.
In an interview with CCTV on February 24, Liu Liang said that academician Zhong Nanshan called him on the morning of February 24, saying that doctors at the front line would wait for the results of the autopsy, otherwise they would not know what to do with the treatment and how to evaluate the treatment effect.
Liu also said preliminary results had begun in the early hours of February 24. The preliminary results are discussed internally, forming a consensus.
According to the report, the lung injury of the dead was obvious. The inflammatory lesions (gray white lesions) were mainly in the left lung. The lung was patchy with naked eyes. Gray white lesions and dark red bleeding were seen. The touch was tough and the spongy feeling of the lung was lost. On the section, a large number of thick secretions can be seen overflowing from the alveoli, and fiber bands can be seen. On the 20th day after admission, the CT films of the control group showed multiple patchy ground glass shadows in both lungs, air bronchogram sign, with the left side as the weight, and fibrous cord shadows in both lower lungs.
Thus, novel coronavirus pneumonia is mainly associated with deep airway and alveolar damage, the report said.
Novel coronavirus pneumonia was previously diagnosed by novel coronavirus pneumonia. The pathological features of the new crown pneumonia were similar to those of SARS and MERS coronavirus. However, from the systematic anatomy of this case, the pulmonary fibrosis and consolidation did not show serious SARS lesions, and the exudative response was more obvious than that of SARS. Only 15 days after death, the course of disease is relatively short, which needs more systematic autopsy data and histopathological verification.
In addition, the report found that the amount of pleural effusion in the dead was small, pale yellow clear liquid, and no large amount of pleural effusion was produced, suggesting that pleural lesions were not serous inflammation. The severe adhesion between the right lung and pleura suggests that this case may be associated with infective pleurisy. Because the clinical data of the patients showed that there was a history of coronary heart disease and angina pectoris, whether there was damage of myocardial and epicardium related to virus infection remains to be further studied.
In addition, the damage of digestive system was not obvious. It is worth mentioning that the small intestine is characterized by segmental dilatation and stenosis (similar to beading), and more autopsies are needed for individual cases or general manifestations. There is no obvious abnormality in the macroscopic view of the spleen. Histopathological study is needed to determine whether there is pathological change. The appearance of kidney is granular pyknosis, which is related to basic diseases.
As for the nervous system, brain edema and mild atrophy of cerebral cortex can be seen by naked eyes. Combined with clinical data, the patient is old and has multiple cerebral infarction and sequelae of cerebrovascular disease. There is no infection specific manifestation in naked eyes of brain. Whether the virus invades the central nervous system needs to be verified by histopathology.
Preliminary diagnosis of mucinous secretion in the lungs of 3 cases
As of February 25th, novel coronavirus pneumonia deaths were pathologically dissected by the team of experts, of which 9 were performed by the Liu Liang team, and 3 patients have completed the initial diagnosis of pathology. The results of the study were as follows: (1) the 11 cases of the new crown pneumonia death were pathologically dissected.