Atypical Endovascular Cells in SARS-CoV-2 Pneumonia

Barna, Nicholas; Chapman, Jennifer R.; Hutchins, Kenneth D.; Garavan, Fintan

doi:10.1097/paf.0000000000000626

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Pulmonary artery (PA) thrombosis is a potential complication in severe COVID-19 despite the administration of anticoagulation treatment [5]. In accordance with the theory that endothelium damage is caused by SARS-CoV-2 are several post-mortem autopsy studies, in which diffuse alveolar damage and atypical cells that are thought to be endothelial cells infected via the human angiotensin-converting enzyme 2 receptor (hACE2R) are common findings [6][7][8][9].…”

Section: Introductionmentioning

confidence: 91%

Reversibility of the Enlargement of the Pulmonary Artery in COVID-19 Pneumonia as a Marker of Remission of the Disease

Matthaiou,

Bizymi,

Pagonidis

et al. 2024

JPM

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Coronavirus disease 2019 (COVID-19) pneumonia is associated with extensive pulmonary microangiopathy and the enlargement of the pulmonary artery (PA), while its progression after the remission of the disease has not been investigated yet. The aim was to assess the diametral increase in the PA in COVID-19 pneumonia, as revealed on chest computed tomography (CT), and further investigate its progression. This was a retrospective cohort study of patients with COVID-19 pneumonia, without prior history of pulmonary hypertension, who underwent CT pulmonary angiography before, during, and after the infection. Pulmonary embolism was excluded in all cases. The main PA diameter (MPAD) was assessed in consecutive chest imaging. Statistical analysis was performed with the non-parametric Wilcoxon and Kruskal–Wallis tests, while correlations were performed with the non-parametric Spearman test. A mean ± SD MPAD of 3.1 ± 0.3 cm in COVID-19 pneumonia was significantly decreased to 2.8 ± 0.3 cm in the post-infectious state after 2–18 months in 31 patients (p-value: <0.0001). In a subgroup of six patients with more than one post-COVID-19 CT, a significant further decline in the diameter was observed (p-value: 0.0313). On the other hand, in accordance with the literature, a significant increase in the MPAD during COVID-19 pneumonia was noted in a group of 10 patients with a pre-COVID-19 CT (p-value: 0.0371). The enlargement of the PA is a common finding in COVID-19 pneumonia that regresses after the remission of the disease, indicating that this reversible cardiovascular event is a potential marker of disease activity, while its course in long COVID is yet to be determined.

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Section: Introductionmentioning

confidence: 91%

Reversibility of the Enlargement of the Pulmonary Artery in COVID-19 Pneumonia as a Marker of Remission of the Disease

Matthaiou,

Bizymi,

Pagonidis

et al. 2024

JPM

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“…Although the majority of infections are asymptomatic to mild, acute respiratory distress syndrome has widely been reported, especially in patients with multiple comorbidities. Vascular abnormalities have also been reported in the literature and include endotheliitis, thromboemboli, and atypical endovascular cell morphology 1,2 …”

mentioning

confidence: 96%

“…Vascular abnormalities have also been reported in the literature and include endotheliitis, thromboemboli, and atypical endovascular cell morphology. 1 , 2 …”

mentioning

confidence: 99%

“…Vascular abnormalities have also been reported in the literature and include endotheliitis, thromboemboli, and atypical endovascular cell morphology. 1,2 Isolated arterial dissection occurring without aortic dissection is uncommon but has been reported in the carotid arteries and renal arteries. The splanchnic circulation comprises the gastric, pancreatic, hepatic, splenic, and intestinal circulations.…”

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confidence: 99%

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Spontaneous Multiple Arterial Dissection in a COVID-19–Positive Decedent

James¹,

Peterson²

2021

Am J Forensic Med Pathol

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Spontaneous multiple arterial dissection (SMAD) is a rarely reported phenomenon and has been previously linked to connective tissue diseases and specifically the genetic mutations in SMAD3 and COL3A1 . Herein we describe a case of SMAD with scattered thrombi in a COVID-19–positive patient with a history of unspecified mitochondrial myopathy. Vasculopathy involved the splenic artery, inferior mesenteric artery, internal mammary arteries, omental arteries, mesenteric arteries, and small renal arteries. Dissections were confirmed by histology in the splenic artery, inferior mesenteric artery, and bilateral renal medullary arteries. Genetic studies were done to rule out SMAD3 and COL3A1 mutations. Because the Smad3 protein has been previously implicated in COVID-19–associated tissue fibrosis, it may play a role in endothelial dysfunction as well.

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Bacterial Superinfections Among Persons With Coronavirus Disease 2019: A Comprehensive Review of Data From Postmortem Studies

Clancy

Schwartz

Kula

et al. 2021

Open Forum Infectious Diseases

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Background Limited clinical data suggest ~16% prevalence of bacterial superinfections among critically ill patients with coronavirus disease 2019 (COVID-19). Methods We reviewed postmortem studies of patients with COVID-19 published in English through 26 September 2020 for histopathologic findings consistent with bacterial lung infections. Results Worldwide, 621 patients from 75 studies were included. The quality of data was uneven, likely because identifying superinfections was not a major objective in 96% (72/75) of studies. Histopathology consistent with potential lung superinfection was reported in 32% (200/621) of patients (22-96 years old; 66% men). Types of infections were pneumonia (95%), abscesses or empyema (3.5%), and septic emboli (1.5%). Seventy-three percent of pneumonias were focal rather than diffuse. Predominant histopathologic findings were intra-alveolar neutrophilic infiltrations that were distinct from those typical of COVID-19-associated diffuse alveolar damage. In studies with available data, 79% of patients received antimicrobial treatment; most common agents were beta-lactam/beta-lactamase inhibitors (48%), macrolides (16%), cephalosoprins (12%), and carbapenems (6%). Superinfections were proven by direct visualization or recovery of bacteria in 25.5% (51/200) of potential cases, and 8% of all patients in postmortem studies. In rank order, pathogens included Acinetobacter baumannii, Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumoniae. Lung superinfections were causes of death in 16% of potential cases, and 3% of all patients with COVID-19. Conclusions Potential bacterial lung superinfections were evident at postmortem examination in 32% of persons who died with COVID-19 (proven, 8%; possible, 24%), but they were uncommonly the cause of death.

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Atypical Endovascular Cells in SARS-CoV-2 Pneumonia

Cited by 4 publications

References 7 publications

Reversibility of the Enlargement of the Pulmonary Artery in COVID-19 Pneumonia as a Marker of Remission of the Disease

Reversibility of the Enlargement of the Pulmonary Artery in COVID-19 Pneumonia as a Marker of Remission of the Disease

Spontaneous Multiple Arterial Dissection in a COVID-19–Positive Decedent

Bacterial Superinfections Among Persons With Coronavirus Disease 2019: A Comprehensive Review of Data From Postmortem Studies

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