SARS-CoV-2-Infection (COVID-19):Clinical Course,viral acute respiratory distress Syndrome (ARDS) and Cause(s) of death.
Prof.Dr. Ramadori Giuliano Pasquale
Unvaccinated but also vaccinated older persons continue to die,after SARS-CoV-nfection, every day, although the infection has been demonstrated to be self-limiting.
Together with local symptoms,such as runny nose and headache, fever is the leading systemic reaction to the local infection.Later,dry cough can also appear.Eight to ten days after the first symptoms, hospitalization may follow, mostly for debilitated patients who may need mechanical ventilation and transfer to the ICU.A significant number of those patients may die during treatment.The most striking macroscopic autopsy finding is a significant weight increase of both congested lungs, as it was observed 100 years ago in victims of the first influenza pandemic,in victims of the asean influenza pandemic 1957 and in SARS-CoV-1 victims 20 years ago.The second most frequent autopsy finding is necrosis of the epithelium of the kidney tubuli as the patognomonic sign of renal fluid insufficiency due to dehydration.Dehydration explains not only the development of respiratory distress, but also appearance of dry cough.Both symptoms cannot be justified by viral damage of the lower respiratory tract as no viral replication has been demonstrated.Death may be due to cardiac failure by hypovolemia.