Browsing by Subject "Diffuse alveolar damage"

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    Earliest histopathological changes in COVID-19 pneumonia with comprehensive gene expression analyses: A case series study
    (Universidad de Murcia, Departamento de Biologia Celular e Histiologia, 2023) Okudela, Koji; Hayashi, Hiroyuki; Yoshimura, Yukihiro; Sasaki, Hiroaki; Miyata, Nobuyuki; Iwashita, Hiromichi; Kataoka, Toshiaki; Matsumura, Mai; Mitsui, Hideaki; Hatayama, Yasuyoshi; Yamashiro, Tsuneo; Ryo, Akihide; Tachikawa, Natsuo
    Aims. In COVID-19 pneumonia, early detection and appropriate treatment are essential to prevent severe exacerbation. Therefore, it is important to understand the initiating events of COVID-19 pneumonia. However, at present, the literature about early stage disease has been very limited. Here, we investigated the earliest histopathological changes and gene expression profiles associated with COVID-19 pneumonia. Methods and Results. We carefully examined 25 autopsied cases with different clinical courses. Dilation of capillaries and edematous thickening of the alveolar septa were found even in areas that macroscopically looked almost normal. Pneumocytes, histocytes/ macrophages, and vascular endothelial cells were immunohistochemically positive for tissue factor, which is an important early responder to tissue injuries. Comprehensive gene expression analyses revealed that those lesions presented differential profiles compared to those of control lungs and were associated with a significant upregulation of the lysosomal pathway. Conclusions. Alveolar capillary dilation and edematous thickening may be the earliest histopathological change detected in COVID-19 pneumonia. Intensive investigations of such lesions may lead to an understanding of the initiating event of not only COVID-19 pneumonia but also of general diffuse alveolar damage.
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    Morphopathological features induced by SARS-CoV-2 infection - a series of 57 autopsies
    (Universidad de Murcia, Departamento de Biologia Celular e Histiologia, 2023) Deacu, Mariana; Enciu, Manuela; Nicolau, Antonela Anca; Bălţătescu, Gabriela Izabela; Neculai-Cândea, Lavinia Simona; Deacu, Sorin; Popa, Marius Florentin
    Background. COVID-19 is a systemic disease with multiorgan damage, which requires a better understanding and deepening of histopathogenesis in order to improve treatment. Autopsy remains a gold standard to establish certain diagnoses and to integrate the morphological spectrum of lung lesions, explaining the cause of death, into a clinical context. Methods and Results. The study included 57 autopsies performed during 2020-2021 associated with SARS-CoV-2 infection. Among the autopsies we performed, diffuse alveolar damage (DAD) was the most common pulmonary morphological change, 31.8% of them with acute or exudative phase and 33.3% with proliferative phase of DAD. Acute fibrous organizing pneumonia or organizing pneumonia with fibrous remodeling processes and pulmonary fibrosis were rarely observed. The most unfavorable outcome and death associated with SARS-CoV-2 infection was frequent in older men, with a high rate of comorbidities. Microscopically, SARS-CoV-2 presents many common aspects with MERS-CoV and SARS-CoV-1, such as alveolar hyaline membrane, desquamated alveolar cells, alveolar edema and alveolar and interstitial lymphocyte and monocytes infiltration. Conclusions. Our study includes a large number of autopsies on patients with SARS-CoV-2 infection performed in Romania. COVID 19 associated pneumonia combines classical aspects of alveolar and interstitial pneumonia with some peculiarities. Autopsies are of major importance in understanding SARS-CoV-2 infection