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Retrospective Analysis of 61 Cases of Children Died of Viral Pneumonia.
Abstract: Objective To retrospectively analyze the forensic and pathological postmortem examination and clinical data of children who died of viral pneumonia in identification of cause of death cases and to discuss the clinical characteristics and pathological features of viral pneumonia in children, in order to provide reference to pathological diagnosis of viral pneumonia in children caused by severe acute respiratory syndrome coronavirus-2 （SARS-CoV-2） infection. Methods In this study, postmortem examination data from the institute of 61 cases of children whose cause of death were identified as viral pneumonia in recent years were collected. The gender, age, clinical symptoms and pathological features were comparatively analyzed. Results Among the 61 cases of children who died of viral pneumonia, most were within 2 years old （83.61%）, and a large proportion died within 2 weeks after the onset of the disease （91.80%）. General changes in postmortem examination included respiratory mucosal hyperemia, pleural effusion, pulmonary swelling, variegated pulmonary pleura and serosa, focal hemorrhage and edema of the cut surface of the lung. A large proportion of children had enlarged mesenteric lymph nodes （83.61%）, and 21.31% of children had thymic dysplasia. Histopathological changes included pulmonary alveoli and interstitial edema, pulmonary hemorrhage, alveolar epithelial shedding, serous and （or） fibrous exudation in the alveoli, formation of viral inclusions, formation of transparent membranes, infiltration of inflammatory cells that mainly consisted of macrophages and lymphocytes in interstitial substance and alveoli. Viral infections often affected the heart and gastrointestinal tract. Conclusion The clinical symptoms of children with viral pneumonia are difficult to notice, and because their immune system is not fully developed and they have poor autoimmunity, they can easily get into a critical condition and even die. Through analysis of the characteristics of forensic autopsy and histopathological changes, this study could provide reference for pathological diagnosis of viral pneumonia.
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