Histopathological features in fatal COVID-19 acute respiratory distress syndrome

Copyright © 2021 Elsevier España, S.L.U. y SEMICYUC. All rights reserved..

BACKGROUND: COVID-19 acute respiratory distress syndrome (ARDS) shares the common histological hallmarks with other forms of ARDS. However, the chronology of the histological lesions has not been well established.

OBJECTIVE: To describe the chronological histopathological alterations in the lungs of patients with COVID-19 related ARDS.

DESIGN: A prospective cohort study was carried out.

SETTING: Intensive Care Unit of a tertiary hospital.

PATIENTS: The first 22 consecutive COVID-19 deaths.

MEASUREMENTS: Lung biopsies and histopathological analyses were performed in deceased patients with COVID-19 related ARDS. Clinical data and patient course were evaluated.

RESULTS: The median patient age was 66 [63-74] years; 73% were males. The median duration of mechanical ventilation was 17 [8-24] days. COVID-19 induced pulmonary injury was characterized by an exudative phase in the first week of the disease, followed by a proliferative/organizing phase in the second and third weeks, and finally an end-stage fibrosis phase after the third week. Viral RNA and proteins were detected in pneumocytes and macrophages in a very early stage of the disease, and were no longer detected after the second week.

LIMITATION: Limited sample size.

CONCLUSIONS: The chronological evolution of COVID-19 lung histopathological lesions seems to be similar to that seen in other forms of ARDS. In particular, lung lesions consistent with potentially corticosteroid-sensitive lesions are seen.

Media Type:

Electronic Article

Year of Publication:

2021

Contained In:

Medicina intensiva - Vol. 45, No. 5 (2021), p. 261-270

Language:

English

Other Title:

Características hispotatológicas en el síndrome de dificultad respiratoria aguda asociado a COVID-19 mortal

Contributors:

Merdji, H
Mayeur, S
Schenck, M
Oulehri, W
Clere-Jehl, R
Cunat, S
Herbrecht, J-E
Janssen-Langenstein, R
Nicolae, A
Helms, J
Meziani, F
Chenard, M-P
CRICS TRIGGERSEP Group (Clinical Research in Intensive Care, Sepsis Trial Group for Global Evaluation, Research in Sepsis)

Links:

Volltext

Keywords:

Aged
COVID-19
COVID-19 related acute respiratory distress syndrome
Female
France
Histopathology
Histopatología
Humans
Journal Article
Lung
Male
Middle Aged
Multicenter Study
Prospective Studies
Pulmonary Embolism
Research Support, Non-U.S. Gov't
Respiration, Artificial
Respiratory Distress Syndrome
Síndrome de dificultad respiratoria aguda asociada a COVID-19
SARS-CoV-2
Time Factors

Notes:

Date Completed 26.05.2021

Date Revised 07.06.2021

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1016/j.medin.2021.02.007

PMID:

33766409

PPN (Catalogue-ID):

NLM324310463