Pharyngolaryngitis Due to COVID-19 : Autopsy Case Reports

There were 70 cases autopsied at the Tokyo Metropolitan Coroner’s Office from April 2020 to August 2023 that tested positive for novel coronavirus infection. Of these, pharyngolaryngitis due to new-type coronavirus infection was diagnosed as the cause of death in four cases. We will discuss pharyngolaryngitis caused by new-type coronavirus infection, focusing on these autopsy reports. Three of the four cases had severe disease factors, and hypoadrenalism was noted in one of the others. Three cases were confirmed to have had a fever, but none sought medical attention. In one case, a security camera caught the patient shortly before her death, suggesting that her symptoms may have progressed rapidly and led to her death. A gross examination of the cases revealed mild edema but intense erythema and a high degree of inflammatory cell infiltration histologically. Inflammatory cell infiltration of the mucosal epithelium was present, suggesting that impairment of the barrier function by epithelial damage had led to an increased degree of inflammation. In one case, there was a high degree of inflammatory cell infiltration within the muscles of the larynx, suggesting the possibility of nerve or muscle damage. Although pharyngolaryngitis caused by novel coronavirus infection is often regarded as a mild disease because of its symptoms, it is important to note that it can be fatal and has a rapid onset.