{
  "abstract": "A man in his early 60s with no relevant medical history was admitted to intensive care with severe acute respiratory failure due to COVID-19 pneumonia. He required immediate intubation and mechanical ventilation. Imaging showed bilateral ground-glass opacities. Laboratory tests revealed elevated inflammatory markers, lymphopenia and coagulopathy. He received lung-protective ventilation, prone positioning, neuromuscular blockade, vasopressors and subcutaneous enoxaparin 40 mg daily. Despite initial improvement, he developed multiorgan dysfunction: acute kidney injury requiring renal replacement therapy, hepatocellular dysfunction (peak aspartate aminotransferase 458 U/L, alanine aminotransferase 372 U/L, bilirubin 6.3 mg/dL) and worsening haemodynamic instability. Peak creatinine and urea were 4.2 mg/dL and 184 mg/dL. Repeated cultures and imaging excluded viral, bacterial and fungal infections. Cytomegalovirus and herpes simplex virus PCR were negative. Glucose was controlled; propofol use was not prolonged.",
  "authors": [
    {
      "affiliations": [
        "Intensive Care Unit, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain",
        "Intensive Care Unit, Hospital Universitario Vithas Madrid Aravaca, Madrid, Spain",
        "School of Medicine, CEU San Pablo University, Madrid, Spain"
      ],
      "name": "Ánxela V González"
    },
    {
      "affiliations": [
        "Faculty of Health Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Madrid, Spain",
        "National Centre for Electron Microscopy (ICTS-CNME), Complutense University of Madrid, Madrid, Spain"
      ],
      "name": "Ana MV Montaña"
    },
    {
      "affiliations": [
        "National Centre for Electron Microscopy (ICTS-CNME), Complutense University of Madrid, Madrid, Spain"
      ],
      "name": "Mariona C Piris"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain"
      ],
      "name": "Laura Prieto-Pérez"
    }
  ],
  "title": "Postmortem ultrastructural lung and liver injury in a critically ill COVID-19 patient",
  "uid": "8131f4e3-357b-58ae-ae32-4450fc98f57c"
}