Since its initial recognition in December 2019, Coronavirus disease 19 (COVID-19) has quickly spread to a pandemic infectious disease. The causative agent has been recognized as a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), primarily affecting the respiratory tract. To date, no vaccines are available nor any specific treatment. To limit the number of infections, strict directives have been issued by governments that have been translated into equally rigorous guidelines notably for post-mortem examinations by international and national scientific societies. The recommendations for biosafety control required during specimen collection and handling have strongly limited the practice of autopsies of the COVID-19 patients to a few adequate laboratories. A full pathological examination has always been considered an important tool to better understand the pathophysiology of diseases, especially when the knowledge of an emerging disorder is limited and the impact on the healthcare system is significant. The first evidence of diffuse alveolar damage in the context of an acute respiratory distress syndrome has now been joined by the latest findings that report a more complex scenario in COVID-19, including a vascular involvement and a wide spectrum of associated pathologies. Ancillary tools such as electron microscopy and molecular biology used on autoptic tissue samples from autopsy are also significantly contributing to confirm and/or identify new aspects useful for a deeper knowledge of the pathogenetic mechanisms. This article will review and summarize the pathological findings described in COVID-19 until now, chiefly focusing on the respiratory tract, highlighting the importance of autopsy towards a better knowledge of this disease.

自 2019 年 12 月首次认识以来，冠状病毒病 19 (COVID-19) 已迅速传播为一种大流行传染病。病原体已被确认为一种新型冠状病毒，即严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2)，主要影响呼吸道。迄今为止，还没有可用的疫苗，也没有任何具体的治疗方法。为了限制感染数量，各国政府发布了严格的指令，这些指令已转化为同样严格的指南，特别是国际和国家科学协会的尸检指南。标本采集和处理过程中所需的生物安全控制建议极大地限制了对 COVID-19 患者进行尸检的做法仅限于少数足够的实验室。完整的病理检查一直被认为是更好地了解疾病病理生理学的重要工具，特别是当对新出现的疾病的了解有限且对医疗保健系统的影响重大时。急性呼吸窘迫综合征背景下弥漫性肺泡损伤的第一个证据现在与最新的发现相结合，报告了 COVID-19 中更复杂的情况，包括血管受累和广泛的相关病理。用于尸检自动光学组织样本的电子显微镜和分子生物学等辅助工具也显着有助于确认和/或识别有助于更深入了解发病机制的新方面。本文将回顾和总结迄今为止在 COVID-19 中描述的病理结果，主要关注呼吸道，强调尸检对于更好地了解这种疾病的重要性。