Histopathological features in fatal COVID-19 acute respiratory distress syndrome
© 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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:45 |
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| Enthalten in: |
Medicina intensiva - 45(2021), 5 vom: 01. Juni, Seite 261-270 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Merdji, H [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 11.06.2021 Date Revised 16.09.2021 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.medin.2021.02.007 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM326028226 |
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| 100 | 1 | |a Merdji, H |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Histopathological features in fatal COVID-19 acute respiratory distress syndrome |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 11.06.2021 | ||
| 500 | |a Date Revised 16.09.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2021 Elsevier España, S.L.U. y SEMICYUC. All rights reserved. | ||
| 520 | |a 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 | ||
| 520 | |a Objective: To describe the chronological histopathological alterations in the lungs of patients with COVID-19 related ARDS | ||
| 520 | |a Design: A prospective cohort study was carried out | ||
| 520 | |a Setting: Intensive Care Unit of a tertiary hospital | ||
| 520 | |a Patients: The first 22 consecutive COVID-19 deaths | ||
| 520 | |a Measurements: Lung biopsies and histopathological analyses were performed in deceased patients with COVID-19 related ARDS. Clinical data and patient course were evaluated | ||
| 520 | |a 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 | ||
| 520 | |a Limitation: Limited sample size | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a ACE2, angiotensin-converting enzyme 2 | |
| 650 | 4 | |a AFOP, acute fibrinous and organizing pneumonia | |
| 650 | 4 | |a ARDS, acute respiratory distress syndrome | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a COVID-19 related acute respiratory distress syndrome | |
| 650 | 4 | |a COVID-19, coronavirus infectious disease | |
| 650 | 4 | |a DAD, diffuse alveolar damage | |
| 650 | 4 | |a HE, hematoxylin–eosin | |
| 650 | 4 | |a Histopathology | |
| 650 | 4 | |a ISH, in situ hybridization | |
| 650 | 4 | |a NMBD, neuromuscular blocking drugs | |
| 650 | 4 | |a RT-PCR, Reverse Transcriptase-Polymerase chain reaction | |
| 650 | 4 | |a SAPSII, simplified acute physiology score | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a SOFA, Sequential Organ Failure Assessment | |
| 650 | 4 | |a VILI, ventilator induced lung injury | |
| 700 | 1 | |a Mayeur, S |e verfasserin |4 aut | |
| 700 | 1 | |a Schenck, M |e verfasserin |4 aut | |
| 700 | 1 | |a Oulehri, W |e verfasserin |4 aut | |
| 700 | 1 | |a Clere-Jehl, R |e verfasserin |4 aut | |
| 700 | 1 | |a Cunat, S |e verfasserin |4 aut | |
| 700 | 1 | |a Herbrecht, J-E |e verfasserin |4 aut | |
| 700 | 1 | |a Janssen-Langenstein, R |e verfasserin |4 aut | |
| 700 | 1 | |a Nicolae, A |e verfasserin |4 aut | |
| 700 | 1 | |a Helms, J |e verfasserin |4 aut | |
| 700 | 1 | |a Meziani, F |e verfasserin |4 aut | |
| 700 | 1 | |a Chenard, M-P |e verfasserin |4 aut | |
| 700 | 0 | |a CRICS TRIGGERSEP Group (Clinical Research in Intensive Care, Sepsis Trial Group for Global Evaluation, Research in Sepsis) |e verfasserin |4 aut | |
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