Journal
NATIONAL SCIENCE REVIEW
Volume 7, Issue 12, Pages 1868-1878Publisher
OXFORD UNIV PRESS
DOI: 10.1093/nsr/nwaa247
Keywords
COVID-19; SARS-CoV-2; autopsy; histopathology; immune disorder
Categories
Funding
- Science and Technology Project for Novel Coronavirus Pneumonia of Chongqing Health Committee [2020NCPZX01]
- Science and Technology Project for Novel Coronavirus Pneumonia of Chongqing Science and Technology Commission [CSTC2020jscx-fyzxX0037]
- Army Medical University [2020XGBD08]
- Ministry of Science and Technology of China [2020YFC0844700]
- Clinical Foundation of TongjiHospital, Tongji Medical College, Huazhong University of Science and Technology [XXGZBDYJ010]
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Systematic autopsy and comprehensive pathological analyses of COVID-19 decedents should provide insights into the disease characteristics and facilitate the development of novel therapeutics. In this study, we report the autopsy findings from the lungs and lymphatic organs of 12 COVID-19 decedents findings that evaluated histopathological changes, immune cell signature and inflammatory factor expression in the lungs, spleen and lymph nodes. Here we show that the major pulmonary alterations included diffuse alveolar damage, interstitial fibrosis and exudative inflammation featured with extensive serous and fibrin exudates, macrophage infiltration and abundant production of inflammatory factors (IL-6, IP-10, TNF alpha and IL-1 beta). The spleen and hilar lymph nodes contained lesions with tissue structure disruption and immune cell dysregulation, including lymphopenia and macrophage accumulation. These findings provide pathological evidence that links injuries of the lungs and lymphatic organs with the fatal systematic respiratory and immune malfunction in critically ill COVID-19 patients.
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