期刊
HELIYON
卷 7, 期 5, 页码 -出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.heliyon.2021.e07134
关键词
COVID-19; Autopsy; ARDS
资金
- Stockholms LaEurons Landsting
The main pathology of COVID-19 was found in the lung parenchyma, with a massive accumulation of CD163+ macrophages and the disappearance of other immune cells being the dominant inflammatory response. Lung consolidations were caused by regenerative response, proliferation, and neovascularization.
Most COVID-19 victims are old and die from unrelated causes. Here we present twelve complete autopsies, including two rapid autopsies of young patients where the cause of death was COVID-19 ARDS. The main virus induced pathology was in the lung parenchyma and not in the airways. Most coagulation events occurred in the intra-alveolar and not in the intra-vascular space and the few thrombi were mainly composed of aggregated thrombocytes. The dominant inflammatory response was the massive accumulation of CD163 + macrophages and the disappearance of T killer, NK and B-cells. The virus was replicating in the pneumocytes and macrophages but not in bronchial epithelium, endothelium, pericytes or stromal cells. The lung consolidations were produced by a massive regenerative response, stromal and epithelial proliferation and neovascularization. We suggest that thrombocyte aggregation inhibition, angiogenesis inhibition and general proliferation inhibition may have a roll in the treatment of advanced COVID-19 ARDS.
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