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RÉSUMÉ
Introduction. Le coronavirus 2 du syndrome respiratoire aigu sévère (SRAS-CoV-2), responsable de la Covid-19 continue de préoccuper les scientifiques. Alors que l’on prédisait une hécatombe en Afrique noire, les auteurs ont exploré les lésions histopathologiques observées sur les poumons de certains patients décédés à Yaoundé. Méthodologie. Il s’agissait d’une étude transversale prospective et descriptive. Respectant toutes les conditions éthiques et de biosécurité, des échantillons nécropsiques pulmonaires étaient collectés puis analysées en fonction de quelques caractéristiques sociodémographiques ou clinicobiologiques. Résultats. Parmi les 83 patients décédés, 59 % étaient des hommes, sex-ratio : 1,44. Leur âge moyen était de 63,43 ans avec des extrêmes de 20 et 87 ans ; 59 % en avaient plus de 60. Tous avaient reçu de l’oxygène en hospitalisation dont la durée moyenne était de 4,16 jours pour les hommes contre 4,52 pour les femmes. Les D-Dimères étaient de 4 644,97 nanogrammes par millilitre (ng/mL) de sang chez les hommes contre 4 366,49 chez les femmes. Les comorbidités objectivées comprenaient : hypertension artérielle, diabète, maladies cardiovasculaires, obésité, maladies rénales chroniques, tuberculose et VIH. Les lésions élémentaires, tout comme les divers changements histopathologiques pulmonaires observés associaient globalement une inflammation alvéolo-interstitielle à une endothélite pouvant expliquer indubitablement le dysfonctionnement systémique de la microcirculation sanguine dans les poumons et autres organes. Conclusion. Les lésions pulmonaires observées dans notre échantillon de patients décédés de SRAS-CoV-2 sont aussi bien identiques que celles déjà décrites hors de l’Afrique noire. Cependant, n’étant pas particulièrement pathognomoniques, toutes tentatives de comparaison statistique restent très hasardeuses.
ABSTRACT
Introduction. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for Covid-19, continues to concern scientists. While a hecatomb was predicted in black Africa, the authors explored the histopathological lesions observed on the lungs of certain patients who died in Yaoundé. Methodology. This was a cross sectional prospective and descriptive study. Respecting all ethical and biosafety conditions, lung necropsy samples were collected and then analyzed according to a few socio-demographic or clinico-biological characteristics. Results. Of the 83 patients who died, 59% were men, sex ratio: 1.44. Their average age was 63.43 years with extremes of 20 and 87 years; 59% had more than 60. All had received oxygen during hospitalization, the average duration of which was 4.16 days for men compared to 4.52 for women. D-Dimers were 4 644.97 nanograms per milliliter (ng/mL) of blood in men versus 4 366.49 in women. Objectified comorbidities included: high blood pressure, diabetes, cardiovascular disease, obesity, chronic kidney disease, tuberculosis and HIV. The basic lesions, as well as the various pulmonary histopathological changes observed, globally associated an alveolar-interstitial inflammation with an endothelitis which could undoubtedly explain the systemic dysfunction of the blood microcirculation in the lungs and other organs. Conclusion. The lung lesions in the sample of patients who died of SARS-CoV-2 are identical to those already described outside black Africa. However, as they are not particularly pathognomonic, all attempts at statistical comparison remain very risky.

Keywords

COVID-19 SARS-CoV-2 Post-mortem Histopathology Infectious disease Inflammation Virus COVID-19 SARS-CoV-2 Post-mortem Histopathologie Maladie infectieuse Inflammation Virus

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Mendimi Nkodo J.M, Ngah Komo M.E, Ngo Pambe C.J., Poka Mayap V, Olinga Medjo U., Ouethy M., Onana Ngono I., Affana A. L, Ndam V., Mpile V., Kome S.S., Nguema V., Ateba Mimfoumou G, Kabeyene Okono A.C., Atangana P.J.A., Pefura Yone E., Mbongo’o G.C., Kuaban C., Afane Ze E., Tejiokem M., & Ze Minkande J. (2023). Morbidité et Histomorphologie Pulmonaire des Patients COVID-19 à Yaoundé. HEALTH SCIENCES AND DISEASE, 24(3). https://doi.org/10.5281/hsd.v24i3.4309
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References

  1. Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020 Mar 12;579(7798):265–9.
  2. World Health Organization. Infection prevention and control for the safe management of a dead body in the context of COVID-19: interim guidance, 24 March 2020 [Internet]. World Health Organization; 2020 [cited 2022 May 24]. Report No.: WHO/COVID-19/lPC_DBMgmt/2020.1. Available from: https://apps.who.int/iris/handle/10665/331538
  3. Centre de Coordination des Opérations d’Urgence de Santé Publique (CCOUSP) Ministère de la Santé Publique (MINSANTE). Rapport de situation COVID 19 au Cameroun. N°91, Période du 18 au 25 août 2021.
  4. Osibogun A, Balogun M, Abayomi A, Idris J, Kuyinu Y, Odukoya O, et al. Outcomes of COVID-19 patients with comorbidities in southwest Nigeria. PLoS One [Internet]. 2021 Mar 15;16(3). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7959379/
  5. Ray A, Jain D, Agarwal S, Swaroop S, Goel A, Das P, et al. Clinico-pathological features in fatal Covid-19 Infection: A Preliminary Experience of a Tertiary Care Centre in North India using Post-Mortem Minimally Invasive Tissue Biopsies. medRxiv. 2020 Nov 16;2020.11.12.20229658.
  6. Stefanie Deinhardt-Emmer , Daniel Wittschieber , Juliane Sanft et al. Early postmortem mapping of SARS-CoV-2 RNA in patients with COVID-19 and the correlation with tissue damage. 2021 Mar 30;10:e60361. doi: 10.7554/eLife.60361.
  7. Fiorella Calabrese, Federica Pezzuto, Francesco Fortarezza et al. Pulmonary pathology and COVID-19: lessons from autopsy. The experience of European Pulmonary Pathologists. Virchows Arch. 2020 Sep;477(3):359-372.doi: 10.1007/s00428-020-02886-6. Epub 2020 Jul 9.
  8. Xh Y, Ty L, Zc H, Yf P, Hw L, Sc Y, et al. [A pathological report of three COVID-19 cases by minimal invasive autopsies]. Zhonghua Bing Li Xue Za Zhi. 2020 May 1;49(5):411–7.
  9. Walter O, Roberto O, Víctor A et al. A review of the main histopathological findings in coronavirus disease 2019. Human Pathology. 2020 Nov 1;105:74–83.
  10. McMullen P, Pytel P, Snyder A, Smith H, Vickery J, Brainer J, et al. A series of COVID-19 autopsies with clinical and pathologic comparisons to both seasonal and pandemic influenza. The Journal of Pathology: Clinical Research [Internet]. n/a(n/a). Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/cjp2.220
  11. Barton LM, Duval EJ, Stroberg E, Ghosh S, Mukhopadhyay S. COVID-19 Autopsies, Oklahoma, USA. American Journal of Clinical Pathology. 2020 May 5;153(6):725–33.
  12. Nicholson AG, Osborn M, Devaraj A, Wells AU. COVID‐19 related lung pathology: old patterns in new clothing? Histopathology. 2020 Aug;77(2):169–72.
  13. Deshpande C. Thromboembolic Findings in COVID-19 Autopsies: Pulmonary Thrombosis or Embolism? Ann Intern Med. 2020 May 15;173(5):394–5.
  14. Carsana L, Sonzogni A, Nasr A, Rossi RS, Pellegrinelli A, Zerbi P, et al. Pulmonary post-mortem findings in a series of COVID-19 cases from northern Italy: a two-centre descriptive study. Lancet Infect Dis. 2020;20(10):1135–40.
  15. Dolhnikoff M, Duarte-Neto AN, Monteiro RA de A, Silva LFF da, Oliveira EP de, Saldiva PHN, et al. Pathological evidence of pulmonary thrombotic phenomena in severe COVID-19. Journal of Thrombosis and Haemostasis. 2020;18(6):1517–9.
  16. Salerno M, Sessa F, Piscopo A, Montana A, Torrisi M, Patanè F, et al. No Autopsies on COVID-19 Deaths: A Missed Opportunity and the Lockdown of Science. Journal of Clinical Medicine. 2020 May;9(5):1472.
  17. Rakislova N, Marimon L, Ismail MR, Carrilho C, Fernandes F, Ferrando M, et al. Minimally Invasive Autopsy Practice in COVID-19 Cases: Biosafety and Findings. Pathogens. 2021 Apr;10(4):412.
  18. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet Respiratory Medicine. 2020 Apr;8(4):420–2.
  19. Hemant Kumar, Preeti Gupta, Shobhit Shakya et al. Predictors of Mortality in Patients of COVID-19 Pneumonia in Intensive Care Unit. Journal of Clinical and Diagnostic Research. 2021 Aug, Vol-15(8): OC11-OC14
  20. Sperhake JP. Autopsies of COVID-19 deceased? Absolutely! Leg Med (Tokyo). 2020 Nov;47:101769.
  21. Kristijan S, Klaus V, Lisa S et al. COVID-19 autopsies: Procedure, technical aspects and cause of fatal course. Experiences from a single-center. Pathology - Research and Practice. 2021 Jan 1;217:153305.
  22. Edler C, Schröder AS, Aepfelbacher M, Fitzek A, Heinemann A, Heinrich F, et al. Dying with SARS-CoV-2 infection—an autopsy study of the first consecutive 80 cases in Hamburg, Germany. Int J Legal Med. 2020 Jul 1;134(4):1275–84.
  23. Girish P Vakrani and Tanuja Nambakam, Outcome of COVID-19 in Patients Requiring Haemodialysis. Journal of Clinical and Diagnostic Research. 2021 Nov, Vol-15(11): OC23-OC25
  24. Pomara C, Salerno M, Sessa F, Esposito M, Barchitta M, Ledda C, et al. Safe Management Strategies in Clinical Forensic Autopsies of Confirmed COVID-19 Cases. Diagnostics. 2021 Mar;11(3):457.
  25. P Boor, P Erahhom, A Hartman et al. [Practical aspects of COVID-19 autopsies]. Pathologe. 2021 Feb 24;42(2):197–207.