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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Lancet+Infect+Dis
2020 ; 20
(10
): 1135-1140
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gab.com Text
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Pulmonary post-mortem findings in a series of COVID-19 cases from northern Italy:
a two-centre descriptive study
#MMPMID32526193
Carsana L
; Sonzogni A
; Nasr A
; Rossi RS
; Pellegrinelli A
; Zerbi P
; Rech R
; Colombo R
; Antinori S
; Corbellino M
; Galli M
; Catena E
; Tosoni A
; Gianatti A
; Nebuloni M
Lancet Infect Dis
2020[Oct]; 20
(10
): 1135-1140
PMID32526193
show ga
BACKGROUND: COVID-19 is characterised by respiratory symptoms, which deteriorate
into respiratory failure in a substantial proportion of cases, requiring
intensive care in up to a third of patients admitted to hospital. Analysis of the
pathological features in the lung tissues of patients who have died with COVID-19
could help us to understand the disease pathogenesis and clinical outcomes.
METHODS: We systematically analysed lung tissue samples from 38 patients who died
from COVID-19 in two hospitals in northern Italy between Feb 29 and March 24,
2020. The most representative areas identified at macroscopic examination were
selected, and tissue blocks (median seven, range five to nine) were taken from
each lung and fixed in 10% buffered formalin for at least 48 h. Tissues were
assessed with use of haematoxylin and eosin staining, immunohistochemical
staining for inflammatory infiltrate and cellular components (including staining
with antibodies against CD68, CD3, CD45, CD61, TTF1, p40, and Ki-67), and
electron microscopy to identify virion localisation. FINDINGS: All cases showed
features of the exudative and proliferative phases of diffuse alveolar damage,
which included capillary congestion (in all cases), necrosis of pneumocytes (in
all cases), hyaline membranes (in 33 cases), interstitial and intra-alveolar
oedema (in 37 cases), type 2 pneumocyte hyperplasia (in all cases), squamous
metaplasia with atypia (in 21 cases), and platelet-fibrin thrombi (in 33 cases).
The inflammatory infiltrate, observed in all cases, was largely composed of
macrophages in the alveolar lumina (in 24 cases) and lymphocytes in the
interstitium (in 31 cases). Electron microscopy revealed that viral particles
were predominantly located in the pneumocytes. INTERPRETATION: The predominant
pattern of lung lesions in patients with COVID-19 patients is diffuse alveolar
damage, as described in patients infected with severe acute respiratory syndrome
and Middle East respiratory syndrome coronaviruses. Hyaline membrane formation
and pneumocyte atypical hyperplasia are frequent. Importantly, the presence of
platelet-fibrin thrombi in small arterial vessels is consistent with
coagulopathy, which appears to be common in patients with COVID-19 and should be
one of the main targets of therapy. FUNDING: None.