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Histopathological observations in COVID-19: a systematic review
  1. Vishwajit Deshmukh1,
  2. Rohini Motwani2,
  3. Ashutosh Kumar3,
  4. Chiman Kumari4,
  5. Khursheed Raza5
  1. 1Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Nagpur, Maharashra, India
  2. 2Department of Anatomy, ESIC Medical College and Hospital, Sanathnagar, Hyderabad, Telangana, India
  3. 3Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
  4. 4Department of Anatomy, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
  5. 5Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Deoghar, Jharkhand, India
  1. Correspondence to Dr Rohini Motwani, Department of Anatomy, ESIC Medical College and Hospital, Sanathnagar, Hyderabad, Telangana, India; rohinimotwani{at}


Background Coronavirus disease-2019 (COVID-19) has caused a great global threat to public health. The World Health Organization (WHO) has declared COVID-19 disease as a pandemic, affecting the human respiratory and other body systems, which urgently demands for better understanding of COVID-19 histopathogenesis.

Objective Data on pathological changes in different organs are still scarce, thus we aim to review and summarise the latest histopathological changes in different organs observed after autopsy of COVID-19 cases.

Materials and methods Over the period of 3 months, authors performed vast review of the articles. The search engines included were PubMed, Medline (EBSCO & Ovid), Google Scholar, Science Direct, Scopus and Bio-Medical. Search terms used were ‘Histopathology in COVID-19’, ‘COVID-19’, ‘Pathological changes in different organs in COVID-19’ or ‘SARS-CoV-2’. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 guidelines were used for review writing.

Result We identified various articles related to the histopathology of various organs in COVID-19 positive patients. Overall, 45 articles were identified as full articles to be included in our study. Histopathological findings observed are summarised according to the systems involved.

Conclusion Although COVID-19 mainly affects respiratory and immune systems, but other systems like cardiovascular, urinary, gastrointestinal tract, reproductive system, nervous system and integumentary system are not spared, especially in elderly cases and those with comorbidity. This review would help clinicians and researchers to understand the tissue pathology, which can help in better planning of the management and avoiding future risks.

  • pathology
  • molecular
  • immunohistochemistry
  • microscopy
  • electron

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.
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  • Handling editor Runjan Chetty.

  • AK, CK and KR contributed equally.

  • Contributors RM: Contribution in writing abstract, tables and histopathology of respiratory system and gastrointestinal system, and image collection. VD: Contribution in writing abstract, tables and histopathology of genital system, and arrangement of references using software. AK, CK and KR: Equally contributed in writing of histopathology of cardiovascular system, nervous system and skin, and contributed to tables and images of respective system.Final review is done by all authors individually.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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