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  1. Article ; Online: Can lung ultrasound predict histologic pattern of lung injury in critically ill patients with COVID-19? Author's reply.

    de Almeida Monteiro, Renata Aparecida / Duarte-Neto, Amaro Nunes / Nascimento Saldiva, Paulo Hilário / Dolhnikoff, Marisa

    Intensive care medicine

    2021  Volume 47, Issue 5, Page(s) 631

    MeSH term(s) COVID-19 ; Critical Illness ; Humans ; Lung/diagnostic imaging ; Lung Injury/diagnostic imaging ; SARS-CoV-2
    Language English
    Publishing date 2021-03-12
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-021-06378-2
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  2. Article: Postmortem chest computed tomography in COVID-19: A minimally invasive autopsy method.

    Savoia, Paulo / Valente Yamada Sawamura, Marcio / de Almeida Monteiro, Renata Aparecida / Nunes Duarte-Neto, Amaro / Morais Martin, Maria da Graça / Dolhnikoff, Marisa / Mauad, Thais / Nascimento Saldiva, Paulo Hilário / da Costa Leite, Claudia / Ferraz da Silva, Luiz Fernando / Cardoso, Ellison Fernando

    European journal of radiology open

    2024  Volume 12, Page(s) 100546

    Abstract: Objectives: Performing autopsies in a pandemic scenario is challenging, as the need to understand pathophysiology must be balanced with the contamination risk. A minimally invasive autopsy might be a solution. We present a model that combines radiology ... ...

    Abstract Objectives: Performing autopsies in a pandemic scenario is challenging, as the need to understand pathophysiology must be balanced with the contamination risk. A minimally invasive autopsy might be a solution. We present a model that combines radiology and pathology to evaluate postmortem CT lung findings and their correlation with histopathology.
    Methods: Twenty-nine patients with fatal COVID-19 underwent postmortem chest CT, and multiple lung tissue samples were collected. The chest CT scans were analyzed and quantified according to lung involvement in five categories: normal, ground-glass opacities, crazy-paving, small consolidations, and large or lobar consolidations. The lung tissue samples were examined and quantified in three categories: normal lung, exudative diffuse alveolar damage (DAD), and fibroproliferative DAD. A linear index was used to estimate the global severity of involvement by CT and histopathological analysis.
    Results: There was a positive correlation between patient mean CT and histopathological severity score indexes - Pearson correlation coefficient (R) = 0.66 (p = 0.0078). When analyzing the mean lung involvement percentage of each finding, positive correlations were found between the normal lung percentage between postmortem CT and histopathology (R=0.65, p = 0.0082), as well as between ground-glass opacities in postmortem CT and normal lungs in histopathology (R=0.65, p = 0.0086), but negative correlations were observed between ground-glass opacities extension and exudative diffuse alveolar damage in histological slides (R=-0.68, p = 0.005). Additionally, it was found is a trend toward a decrease in the percentage of normal lung tissue on the histological slides as the percentage of consolidations in postmortem CT scans increased (R =-0.51, p = 0.055). The analysis of the other correlations between the percentage of each finding did not show any significant correlation or correlation trends (p ≥ 0.10).
    Conclusions: A minimally invasive autopsy is valid. As the severity of involvement is increased in CT, more advanced disease is seen on histopathology. However, we cannot state that one specific radiological category represents a specific pathological correspondent. Ground-glass opacities, in the postmortem stage, must be interpreted with caution, as expiratory lungs may overestimate disease.
    Language English
    Publishing date 2024-01-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2810314-2
    ISSN 2352-0477
    ISSN 2352-0477
    DOI 10.1016/j.ejro.2024.100546
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  3. Article ; Online: Postmortem chest computed tomography in COVID-19

    Paulo Savoia / Marcio Valente Yamada Sawamura / Renata Aparecida de Almeida Monteiro / Amaro Nunes Duarte-Neto / Maria da Graça Morais Martin / Marisa Dolhnikoff / Thais Mauad / Paulo Hilário Nascimento Saldiva / Claudia da Costa Leite / Luiz Fernando Ferraz da Silva / Ellison Fernando Cardoso

    European Journal of Radiology Open, Vol 12, Iss , Pp 100546- (2024)

    A minimally invasive autopsy method

    2024  

    Abstract: Objectives: Performing autopsies in a pandemic scenario is challenging, as the need to understand pathophysiology must be balanced with the contamination risk. A minimally invasive autopsy might be a solution. We present a model that combines radiology ... ...

    Abstract Objectives: Performing autopsies in a pandemic scenario is challenging, as the need to understand pathophysiology must be balanced with the contamination risk. A minimally invasive autopsy might be a solution. We present a model that combines radiology and pathology to evaluate postmortem CT lung findings and their correlation with histopathology. Methods: Twenty-nine patients with fatal COVID-19 underwent postmortem chest CT, and multiple lung tissue samples were collected. The chest CT scans were analyzed and quantified according to lung involvement in five categories: normal, ground-glass opacities, crazy-paving, small consolidations, and large or lobar consolidations. The lung tissue samples were examined and quantified in three categories: normal lung, exudative diffuse alveolar damage (DAD), and fibroproliferative DAD. A linear index was used to estimate the global severity of involvement by CT and histopathological analysis. Results: There was a positive correlation between patient mean CT and histopathological severity score indexes - Pearson correlation coefficient (R) = 0.66 (p = 0.0078). When analyzing the mean lung involvement percentage of each finding, positive correlations were found between the normal lung percentage between postmortem CT and histopathology (R=0.65, p = 0.0082), as well as between ground-glass opacities in postmortem CT and normal lungs in histopathology (R=0.65, p = 0.0086), but negative correlations were observed between ground-glass opacities extension and exudative diffuse alveolar damage in histological slides (R=−0.68, p = 0.005). Additionally, it was found is a trend toward a decrease in the percentage of normal lung tissue on the histological slides as the percentage of consolidations in postmortem CT scans increased (R =−0.51, p = 0.055). The analysis of the other correlations between the percentage of each finding did not show any significant correlation or correlation trends (p ≥ 0.10). Conclusions: A minimally invasive autopsy is valid. As the severity of involvement ...
    Keywords Tomography ; Thorax ; Autopsy ; Pathology ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
    Subject code 610
    Language English
    Publishing date 2024-06-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Histological-ultrasonographical correlation of pulmonary involvement in severe COVID-19.

    Almeida Monteiro, Renata Aparecida / de Oliveira, Ellen Pierre / Nascimento Saldiva, Paulo Hilário / Dolhnikoff, Marisa / Duarte-Neto, Amaro Nunes

    Intensive care medicine

    2020  Volume 46, Issue 9, Page(s) 1766–1768

    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Humans ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-06-03
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-020-06125-z
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  5. Article ; Online: What else in times of COVID-19? The role of minimally invasive autopsy for the differential diagnosis of acute respiratory failure in a case of kala-azar.

    Geber Júnior, João Carlos / Monteiro, Renata Aparecida de Almeida / Rocha, João Wilson Pedro da / Duarte, Edson Luiz Társia / Nicodemo, Elizabete / Munhoz, Olavo / Paiva, Edison Ferreira de / Mauad, Thais / Silva, Luiz Fernando Ferraz da / Saldiva, Paulo Hilario Nascimento / Dolhnikoff, Marisa / Duarte-Neto, Amaro Nunes

    Revista do Instituto de Medicina Tropical de Sao Paulo

    2023  Volume 65, Page(s) e36

    Abstract: Visceral leishmaniasis (VL) is a chronic vector-borne zoonotic disease caused by trypanosomatids, considered endemic in 98 countries, mainly associated with poverty. About 50,000-90,000 cases of VL occur annually worldwide, and Brazil has the second ... ...

    Abstract Visceral leishmaniasis (VL) is a chronic vector-borne zoonotic disease caused by trypanosomatids, considered endemic in 98 countries, mainly associated with poverty. About 50,000-90,000 cases of VL occur annually worldwide, and Brazil has the second largest number of cases in the world. The clinical picture of VL is fever, hepatosplenomegaly, and pancytopenia, progressing to death in 90% of cases due to secondary infections and multi-organ failure, if left untreated. We describe the case of a 25-year-old female who lived in the metropolitan area of Sao Paulo, who had recently taken touristic trips to several rural areas in Southeastern Brazil and was diagnosed post-mortem. During the hospitalization in a hospital reference for the treatment of COVID-19, the patient developed acute respiratory failure, with chest radiographic changes, and died due to refractory shock. The ultrasound-guided minimally invasive autopsy diagnosed VL (macrophages containing amastigote forms of Leishmania in the spleen, liver and bone marrow), as well as pneumonia and bloodstream infection by gram-negative bacilli.
    MeSH term(s) Female ; Humans ; Adult ; Leishmaniasis, Visceral/complications ; Leishmaniasis, Visceral/diagnosis ; Leishmaniasis, Visceral/drug therapy ; Diagnosis, Differential ; Autopsy ; COVID-19/diagnosis ; Brazil ; Respiratory Insufficiency/diagnosis ; COVID-19 Testing
    Language English
    Publishing date 2023-06-01
    Publishing country Brazil
    Document type Case Reports
    ZDB-ID 128928-7
    ISSN 1678-9946 ; 0036-4665
    ISSN (online) 1678-9946
    ISSN 0036-4665
    DOI 10.1590/S1678-9946202365036
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  6. Article ; Online: Use of minimally invasive autopsy during the COVID-19 pandemic and its possibilities in the context of developing countries.

    Melo, Deborah Nunes / Mara Coelho, Tania / Rolim Pinheiro Lima, Giovanna / Gomes Fernandes, Carolina / Cavalcante Fales de Brito Alves, Bruno / Montenegro de Carvalho Araújo, Fernanda / Aparecida de Almeida Monteiro, Renata / Ordi, Jaume / Hilário do Nascimento Saldiva, Paulo / Pamplona de Góes Cavalcanti, Luciano

    PLoS neglected tropical diseases

    2021  Volume 15, Issue 8, Page(s) e0009629

    MeSH term(s) Autopsy/methods ; COVID-19/pathology ; Cause of Death ; Developing Countries ; Humans ; Population Surveillance ; SARS-CoV-2
    Language English
    Publishing date 2021-08-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2429704-5
    ISSN 1935-2735 ; 1935-2735
    ISSN (online) 1935-2735
    ISSN 1935-2735
    DOI 10.1371/journal.pntd.0009629
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  7. Article ; Online: Ultrasound-guided minimally invasive autopsies: A protocol for the study of pulmonary and systemic involvement of COVID-19.

    Monteiro, Renata Aparecida de Almeida / Duarte-Neto, Amaro Nunes / Silva, Luiz Fernando Ferraz da / Oliveira, Ellen Pierre de / Filho, Jair Theodoro / Santos, Glaucia Aparecida Bento Dos / Oliveira, Ilka Regina Souza de / Mauad, Thais / Saldiva, Paulo Hilário do Nascimento / Dolhnikoff, Marisa

    Clinics (Sao Paulo, Brazil)

    2020  Volume 75, Page(s) e1972

    MeSH term(s) Autopsy/methods ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/pathology ; Humans ; Pandemics ; Pneumonia, Viral/pathology ; SARS-CoV-2 ; Ultrasonography, Interventional/methods
    Keywords covid19
    Language English
    Publishing date 2020-05-29
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2182801-5
    ISSN 1980-5322 ; 1807-5932
    ISSN (online) 1980-5322
    ISSN 1807-5932
    DOI 10.6061/clinics/2020/e1972
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  8. Article ; Online: Pathological evidence of pulmonary thrombotic phenomena in severe COVID-19.

    Dolhnikoff, Marisa / Duarte-Neto, Amaro Nunes / de Almeida Monteiro, Renata Aparecida / da Silva, Luiz Fernando Ferraz / de Oliveira, Ellen Pierre / Saldiva, Paulo Hilário Nascimento / Mauad, Thais / Negri, Elnara Marcia

    Journal of thrombosis and haemostasis : JTH

    2020  Volume 18, Issue 6, Page(s) 1517–1519

    MeSH term(s) Anticoagulants ; Betacoronavirus ; COVID-19 ; Coronavirus ; Coronavirus Infections ; Humans ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
    Chemical Substances Anticoagulants
    Keywords covid19
    Language English
    Publishing date 2020-05-12
    Publishing country England
    Document type Letter ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 2112661-6
    ISSN 1538-7836 ; 1538-7933
    ISSN (online) 1538-7836
    ISSN 1538-7933
    DOI 10.1111/jth.14844
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  9. Article ; Online: COVID-19 induces more pronounced extracellular matrix deposition than other causes of ARDS.

    de Souza Xavier Costa, Natália / Ribeiro Júnior, Gabriel / do Nascimento, Ellen Caroline Toledo / de Brito, Jôse Mara / Antonangelo, Leila / Faria, Caroline Silvério / Monteiro, Jhonatas Sirino / Setubal, João Carlos / Pinho, João Renato Rebello / Pereira, Roberta Verciano / Seelaender, Marilia / de Castro, Gabriela Salim / Lima, Joanna D C C / de Almeida Monteiro, Renata Aparecida / Duarte-Neto, Amaro Nunes / Saldiva, Paulo Hilário Nascimento / Ferraz da Silva, Luiz Fernando / Dolhnikoff, Marisa / Mauad, Thais

    Respiratory research

    2023  Volume 24, Issue 1, Page(s) 281

    Abstract: Background: Lung fibrosis is a major concern in severe COVID-19 patients undergoing mechanical ventilation (MV). Lung fibrosis frequency in post-COVID syndrome is highly variable and even if the risk is proportionally small, many patients could be ... ...

    Abstract Background: Lung fibrosis is a major concern in severe COVID-19 patients undergoing mechanical ventilation (MV). Lung fibrosis frequency in post-COVID syndrome is highly variable and even if the risk is proportionally small, many patients could be affected. However, there is still no data on lung extracellular matrix (ECM) composition in severe COVID-19 and whether it is different from other aetiologies of ARDS.
    Methods: We have quantified different ECM elements and TGF-β expression in lung tissue of 28 fatal COVID-19 cases and compared to 27 patients that died of other causes of ARDS, divided according to MV duration (up to six days or seven days or more). In COVID-19 cases, ECM elements were correlated with lung transcriptomics and cytokines profile.
    Results: We observed that COVID-19 cases presented significant increased deposition of collagen, fibronectin, versican, and TGF-β, and decreased decorin density when compared to non-COVID-19 cases of similar MV duration. TGF-β was precociously increased in COVID-19 patients with MV duration up to six days. Lung collagen was higher in women with COVID-19, with a transition of upregulated genes related to fibrillogenesis to collagen production and ECM disassembly along the MV course.
    Conclusions: Fatal COVID-19 is associated with an early TGF-β expression lung environment after the MV onset, followed by a disordered ECM assembly. This uncontrolled process resulted in a prominent collagen deposition when compared to other causes of ARDS. Our data provides pathological substrates to better understand the high prevalence of pulmonary abnormalities in patients surviving COVID-19.
    MeSH term(s) Humans ; Female ; Pulmonary Fibrosis/metabolism ; COVID-19/metabolism ; Extracellular Matrix/metabolism ; Collagen/metabolism ; Lung/metabolism ; Transforming Growth Factor beta/pharmacology ; Respiratory Distress Syndrome/metabolism
    Chemical Substances Collagen (9007-34-5) ; Transforming Growth Factor beta
    Language English
    Publishing date 2023-11-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041675-1
    ISSN 1465-993X ; 1465-993X
    ISSN (online) 1465-993X
    ISSN 1465-993X
    DOI 10.1186/s12931-023-02555-7
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  10. Article: Histological-ultrasonographical correlation of pulmonary involvement in severe COVID-19

    Almeida Monteiro, Renata Aparecida / de Oliveira, Ellen Pierre / Nascimento Saldiva, Paulo Hilário / Dolhnikoff, Marisa / Duarte-Neto, Amaro Nunes

    Intensive Care Med

    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #506080
    Database COVID19

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