This Atlas is the result of the autopsies performed by the Moscow Pathology Service for the posthumous diagnosis of presentations and complications of COVID-19 in 2000 cases, the largest number of autopsies of COVID-19 cases in the world. This was accomplished because in Moscow an autopsy is performed in 100 % of fatal cases with suspected COVID-19 with a detailed clinical and morphological analysis. The results of the studies formed the basis of a new methodology that expands upon WHO Guidelines for Certification and Classification (Coding) of COVID-19 as Cause of Death. Transferring this methodology into practice allowed not only to improve reporting of COVID-19-related deaths, but also had a significant impact on the management strategies of COVID-19 patients. A contribution to the theory of pathology is the introduction of the concept of clinical and morphological “masks” of COVID-19. Atlas presents a wide range of signs and complications of COVID-19, which outline ways for further study of their pathogenesis and morphogenesis, improvement of diagnostics and treatment of patients, and a detailed classification of the causes of death directly or indirectly associated with COVID-19.

Atlas is intended for pathologists, forensic experts, as well as doctors of all clinical specialties and students in medical schools, including those in advanced training programs of continuing medical education.

Contents

• Preface
• Introduction
• Organization of the pathology service for performing autopsies on deceased with COVID-19
• Brief Statistics (2000 autopsies of COVID-19 cases in Moscow)
• Basics of COVID-19 Pathology
• Clinical and morphological classification of causes of death in COVID-19
• Differential diagnosis of pulmonary changes in COVID-19 and other infectious diseases cases
• Differential diagnosis of pulmonary changes in COVID-19 and influenza A/H1N1 cases
• Pathology of COVID-19
• References

Authors:

Zayratyants OV, D.Sc., Professor, Honored Doctor of the Russian Federation, Chief Pathologist at the Moscow Healthcare Department, Chief Expert Pathologist at the Federal Public Health Supervisory Agency Roszdravnadzor for the Central Federal District, Head of the Department of Pathological Anatomy at A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation, Vice President of the Russian Society of Pathologists, Chairman of the Moscow Society of Pathologists;

Samsonova MV, D.Sc., Head of the Laboratory of Pathological Anatomy at the Pulmonology Research Institute, Federal Biomedical Agency of Russia;

Mikhaleva LM, D.Sc., Professor, Director of the Research Institute of Human Morphology, Head of the Pathology Department at the City Clinical Hospital No. 31 of Moscow Healthcare Department, Vice President of the Russian Society of Pathologists;

Chernyaev AL, D.Sc., Professor, Honored Doctor of the Russian Federation, Head of the Department of Fundamental Pulmonology at the Pulmonology Research Institute, Federal Biomedical Agency of Russia, member of the Presidium of the Russian Society of Pathologists;

Mishnev OD, D.Sc., Professor, Honored Doctor of the Russian Federation, Chief Pathologist of the Ministry of Healthcare of the Russian Federation for the Central Federal District, Head of the Department of Pathological Anatomy of the General Medicine Department at N. I. Pirogov Russian National Research Medical University, Vice President of the Russian Society of Pathologists;

Krupnov NM, Ph.D., Chief Pathologist of the Ministry of Health of the Ryazan Region, Head of the D.I. Mastbaum Bureau of Forensic Medicine, Honored Worker of Health Care of the Russian Federation, member of the Presidium of the Russian Society of Pathologists;

Kalinin DV, Ph.D., Head of the Pathology Departments at the A.V. Vishnevsky Scientific Research Surgery Center of the Ministry of Health of Russia and I.V. Davydovsky City Clinical Hospital of Moscow Healthcare Department.

Reviewed by:

Kaktursky LV, D.Sc., Professor, Scientific Director of the Research Institute of Human Morphology, Chief Expert in Pathological Anatomy at the Federal Public Health Supervisory Agency Roszdravnadzor, President of the Russian Society of Pathologists, Corresponding Member of the Russian Academy of Sciences;

Zabozlaev FG, D.Sc., Professor of the Academic Department of Clinical Laboratory Diagnostics and Pathological Anatomy at the Academy of Postgraduate Education of FMBA of Russia, Chief Specialist in Pathological Anatomy of the FMBA of Russia, Vice President of the Russian Society of Pathologists, Honored Doctor of the Russian Federation.

Acknowledgement:

Avdalyan AM, D.Sc., Head of the Pathology Department of City Clinical Hospital No. 40 of Moscow Healthcare Department;

Astakhova OI, Head of the Pathology Department of City Clinical Hospital named after S.I. Spasokukotsky of Moscow Healthcare Department;

Berezovsky YuS, Ph.D., Head of the Pathomorphology Department of Central Research Institute of Tuberculosis of the Ministry of Health of the Russian Federation;

Daabul AS, Head of the Pathology Department of City Clinical Hospital named after M.E. Zhadkevich of Moscow Healthcare Department; Dobryakov AV, Ph.D., Head of the Pathology Department of City Clinical Hospital named after Bakhrushin brothers of Moscow Healthcare Department;

Kelly EI, Ph.D., Head of the Pathology Department of Infectious Diseases Clinical Hospital No. 1 of Moscow Healthcare Department;

Mednikov GN, Head of the Pathology Department of City Clinical Hospital No. 15 named after O.M. Filatov of Moscow Healthcare Department;

Melchenko DS, Ph.D., Associate Professor, Head of the Pathology Department of the Central Clinical Hospital of the Russian Academy of Sciences;

Orekhov OO, Ph.D., Head of the Pathology Department of City Clinical Hospital No. 67 named after L.A. Vorokhobov of Moscow Healthcare Department;

Petrova SYu, Head of the Pathology Department of War Veterans Hospital No. 3 of Moscow Healthcare Department;

Tishkevich OA, Acting Head of the Pathology Department of Infectious Diseases Clinical Hospital No. 2 of Moscow Healthcare Department;

Tsyganov SE, Head of the Pathology Department of City Clinical Hospital No. 4 of Moscow Healthcare Department;

Varyasin VV, Ph.D., Head of the Pathology Department of City Clinical Hospital No. 52 of Moscow Healthcare Department;

Vinogradov SA, Head of the Pathology Department of the MEDSI Clinic (AO MEDSI Group of Companies);

Volkov AV, D.Sc., Head of the Pathology Department of City Clinical Hospital named after E.O. Mukhina of Moscow Healthcare Department, Associate Professor at the Academic Department of Pathological Anatomy of Peoples’ Friendship University of Russia, senior researcher at the Laboratory of connective tissue of the Scientific Research Center for Traumatology and Orthopedics named after N. N. Priorov of the Ministry of Health of the Russian Federation;

Zolotenkova NV, Head of the Pathology Department of City Clinical Hospital No. 17 of Moscow Healthcare Department.

The authors express their sincere gratitude to Dr. Sergey Shigeyev, D. Sc., Head of the Bureau of Forensic Medicine, and all the staff of the Bureau of the Forensic Medicine for continued support, mutual assistance and close cooperation.

Proofreader: Malygina EN, Monakhova VV

Pagemaker: Arzumanov DE

Translators: Karpova ED, Vasilyeva VS, Godovikova IS

Suggested citation:

Pathology of COVID-19: Atlas/Zayratyants OV, Samsonova MV, Mikhaleva LM, Chernyaev AL, Mishnev OD, Krupnov NM, Kalinin DV. Under general editorship of Zayratyants OV. Moscow, Research Institute NIIOZMM, 2020. 140 illustrated pp.