РАДІОЛОГІЧНО-МОРФОЛОГІЧНЕ СПІВСТАВЛЕННЯ ОЗНАК ПАТОЛОГІЧНО ЗМІНЕНИХ ДІЛЯНОК ЛЕГЕНЕВОЇ ТКАНИНИ ПРИ КОРОНАВІРУСНІЙ ХВОРОБІ-2019

The aim is to establish the correspondence of radiological findings to morphological signs of respiratory failure in patients who died as a result of the coronavirus disease-2019. During 2020-2024, there were examined 67 patients aged 37-79 years with acute respiratory insufficiency caused by COVID-19 leading to death. The control group included 48 people aged 43-78 years who died due to acute cardiovascular conditions without having acute infectious diseases. The main in vivo methods performed in both samples were: lung ultrasound, X-ray and CT scan of the chest. Postmortem examination included gross examination of the lungs and pleura, material sampling, and microscopic study. All patients received various types of oxygen support. Among them, 59 (88.1%) patients of the study group and 37 (77.1%) patients of the control group underwent artificial lung ventilation that lasted more than 24 hours, according to which the groups did not statistically significantly differ from each other. In all study group patients, sonography revealed a decrease in lung airiness and bilateral areas of lung parenchyma damage with numerous B-lines. In dynamics, progressive consolidation of lung tissue was observed, as well as the presence of pleural effusion (mainly bilateral), and, in some cases, effusion in the pericardial sac. These changes gradually increased, which led to the deterioration of both respiratory and cardiac parameters in patients. Radiographs of the chest organs showed bilateral polysegmental loci of weak and medium intensity lung tissue opacity with a preference for the periphery, which formed a picture of consolidation with increasing negative dynamics. When a chest CT was performed, the characteristics revealed in the study group were ground-glass-like opacity, which was localized mainly peripherally and around vessels with a tendency to consolidation transformation and linear, reticular thickenings bilaterally. Bronchial patency was preserved in all cases. The variability of the size of the mediastinal lymph nodes in the study group was also noted. The main pathomorphological signs characterizing the gross examination of the lungs included predominantly damage to the lower lobes and tissue on the back surface of the lungs with partial pneumatization of the front sections. Lungs with areas of collapse (focal atelectasis) in some patients had massive areas of blood infiltration and identified signs of thromboembolic syndrome. Some samples were characterized by fibrin deposits on the visceral and parietal pleura, sometimes the development of purulent inflammation – empyema. Mixed characteristics of different phases of diffuse alveolar damage of the lungs with damage to the blood vessels of the lungs, manifested microscopic signs. In patients with respiratory failure who died as a result of coronavirus disease-2019, radiologically visualized areas of ground glass and consolidation of lung tissue in the terminal stage of the disease corresponded to different stages of diffuse alveolar damage.