Autopsy findings from the first known death from Severe Acute Respiratory Syndrome SARS-CoV-2 in Spain

Resumen El nuevo coronavirus SARS-CoV-2, identificado inicialmente en China en diciembre de 2019 puede cursar con un S�ndrome Respiratorio Agudo Severo (SARS) con da�o alveolar masivo y fracaso respiratorio progresivo Presentamos los hallazgos m�s relevantes encontrados en la autopsia cl�nica efectuada en nuestro hospital (Hospital Arnau de Vilanova-Lliria de Valencia) a fecha de 14 de febrero de 2020, al primer paciente fallecido conocido en Espa�a por neumon�a COVID-19 A nivel pulmonar, la autopsia revela cambios t�picos de da�o alveolar difuso (DAD) en fase exudativa y fase proliferativa Se observan c�lulas multinucleadas gigantes, c�lulas tipo smudge intraalveolares y trombosis vasculares El diagn�stico microbiol�gico confirmativo mediante PCR se realiz� 15 d�as despu�s de la autopsia sobre la muestra far�ngea del enfermo tomada durante su ingreso The new coronavirus SARS-CoV-2, first identified in Wuhan, China in December, 2019, can cause Severe Acute Respiratory Syndrome (SARS) with massive alveolar damage and progressive respiratory failure We present the relevant autopsy findings of the first patient known to have died from COVID19 pneumonia in Spain, carried out on the 14th of February, 2020, in our hospital (Hospital Arnau de Vilanova-Lliria, Valencia) Histological examination revealed changes typical of diffuse alveolar damage (DAD) in both the exudative and proliferative phase of acute lung injury Intra-alveolar multinucleated giant cells, smudge cells and vascular thrombosis were present The diagnosis was confirmed by reverse real-time PCR assay on a throat swab sample taken during the patient�s admission The positive result was reported fifteen days subsequent to autopsy