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10.1016/j.anndiagpath.2021.151744

http://scihub22266oqcxt.onion/10.1016/j.anndiagpath.2021.151744
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suck abstract from ncbi


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pmid33991784      Ann+Diagn+Pathol 2021 ; 53 (ä): 151744
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  • Diffuse interstitial pneumonia-like/macrophage activation syndrome-like changes in patients with COVID-19 correlate with length of illness #MMPMID33991784
  • Felix JC; Sheinin YM; Suster D; Ronen N; Ratiani M; Vanden Heuvel T; Winge E; Patton MD; Rau MJ; Ge L; Sun Y; Udhane SS; Langenheim JF; Rui H
  • Ann Diagn Pathol 2021[Aug]; 53 (ä): 151744 PMID33991784show ga
  • OBJECTIVES: Assess the pathologic changes in the lungs of COVID-19 decedents and correlate these changes with demographic data, clinical course, therapies, and duration of illness. METHODS: Lungs of 12 consecutive COVID-19 decedents consented for autopsy were evaluated for gross and histopathologic abnormalities. A complete Ghon "en block" dissection was performed on all cases; lung weights and gross characteristics recorded. Immunohistochemical studies were performed to characterize lymphocytic infiltrates and to assess SARS-CoV-2 capsid protein. RESULTS: Two distinct patterns of pulmonary involvement were identified. Three of 12 cases demonstrated a predominance of acute alveolar damage (DAD) while 9 of 12 cases demonstrated a marked increase in intra-alveolar macrophages in a fashion resembling desquamative interstitial pneumonia or macrophage activation syndrome (DIP/MAS). Two patterns were correlated solely with a statistically significant difference in the duration of illness. The group exhibiting DAD had duration of illness of 5.7 days while the group with DIP/MAS had duration of illness of 21.5 days (t-test p = 0.014). CONCLUSIONS: The pulmonary pathology of COVID-19 patients demonstrates a biphasic pattern, an acute phase demonstrating DAD changes while the patients with a more prolonged course exhibit a different pattern that resembles DIP/MAS-like pattern. The potential mechanisms and clinical significance are discussed.
  • |Adult[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Autopsy[MESH]
  • |COVID-19/complications/diagnosis/*pathology/virology[MESH]
  • |Capsid Proteins/metabolism[MESH]
  • |Comorbidity[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Immunohistochemistry/*methods[MESH]
  • |Lung Diseases, Interstitial/etiology/*pathology/virology[MESH]
  • |Lung/metabolism/*pathology[MESH]
  • |Lymphocytes/metabolism/pathology[MESH]
  • |Macrophage Activation Syndrome/etiology/*pathology/virology[MESH]
  • |Macrophages/pathology[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pulmonary Alveoli/immunology/pathology[MESH]
  • |SARS-CoV-2/genetics[MESH]


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