Multi-organ failure is one of the common causes of fatal outcome in COVID-19 patients. However, the pathogenetic association of the SARS-CoV-2 viral load (VL) level with fatal dysfunctions of the lungs, liver, kidneys, heart, spleen and brain, as well as with the risk of death in COVID-19 patients remains poorly understood. SARS-CoV-2 VL in the lungs, heart, liver, kidneys, brain, spleen and lymph nodes have been measured by RT qPCR using the following formula: N SARS-CoV−2 /N ABL1 × 100. Dissemination of SARS-CoV-2 in 30.5% of cases was mono-organ, and in 63.9% of cases, it was multi-organ. The average SARS-CoV-2 VL in the exudative phase of diffuse alveolar damage (DAD) was 60 times higher than in the proliferative phase. The SARS-CoV-2 VL in the lungs ranged from 0 to 250,281 copies. The “pulmonary factors” of SARS-CoV-2 multi-organ dissemination are the high level of SARS-CoV-2 VL (≥4909) and the exudative phase of DAD. The frequency of SARS-CoV-2 dissemination to lymph nodes was 86.9%, heart–56.5%, spleen–52.2%, liver–47.8%, kidney–26%, and brain–13%. We found no link between the SARS-CoV-2 VL level in the liver, kidneys, and heart and the serum level of CPK, LDH, ALP, ALT, AST and Cr of COVID-19 patients. Isolated detection of SARS-CoV-2 RNA in the myocardium of COVID-19 patients who died from heart failure is possible. The pathogenesis of COVID-19-associated multi-organ failure requires further research in a larger cohort of patients.
【저자키워드】 COVID-19, SARS-CoV-2, Viral load, multiplex real-time polymerase chain reaction, FFPE, multi-organ dissemination, 【초록키워드】 Pathogenesis, lung, LDH, outcome, Brain, kidney, heart failure, Viral, Viral load, qPCR, heart, Lungs, Research, AST, Diffuse alveolar damage, SARS-CoV-2 RNA, dissemination, liver, lymph nodes, spleen, COVID-19 patients, association, ALT, Frequency, COVID-19 patient, Lymph node, DAD, alveolar damage, dysfunction, risk of death, Myocardium, Serum level, SARS-CoV-2 viral load, average, kidneys, multi-organ failure, ABL1, mono, organ, CPK, died, cause, Isolated, ranged, proliferative, ALP, cohort of patients, the SARS-CoV-2, 【제목키워드】 pulmonary, Factor,