Question

A 56-year-old man was diagnosed with COVID-19 and was put on mechanical ventilation. He passed away after a week. What is the likely post-mortem change seen in the lungs?

• A. Thick layer of fibrin lining the alveoli
• B. Acute and chronic alveolar hemorrhage
• C. Perivascular cuffing
• D. Pulmonary artery hypertrophy with increased resistance

Answer 1

The Correct Option is B

In the context of COVID-19, a post-mortem examination of the lungs may reveal several distinct changes due to the underlying pathophysiology of the disease. Given the scenario of a 56-year-old man who succumbed to COVID-19 after a week on mechanical ventilation, the pathological changes observed in the lungs would likely include:

COVID-19 is known to cause acute respiratory distress syndrome (ARDS), and the following pulmonary findings are characteristic:

• Diffuse Alveolar Damage (DAD): This is a common finding in ARDS and can be seen in COVID-19. Initially, there is damage to the alveolar epithelium, which progresses to become more pronounced. However, the immediate post-mortem finding often includes acute and chronic changes due to the severity and duration of illness.
• Acute and Chronic Alveolar Hemorrhage: This finding correlates with the correct option due to extensive damage to the alveolar capillaries leading to bleeding and subsequent organization of the exudate. It reflects both fresh and older bleeding into the alveolar spaces.

Conclusion: The presence of both acute and chronic alveolar hemorrhage suggests a timeline where initial acute bleeding is followed by chronic changes due to ongoing injury and healing processes, which are indicative of COVID-19 pathology in a severe case scenario.