Histologic evidence of tracheal stenosis directly resulting from SARS-CoV-2 tissue infiltration, a case series

Draeger, Tyler B.; Tedesco, Sarah; Andaz, Shahriyour; Gibson, Vanessa R.

doi:10.1186/s13019-022-01839-1

Cited by 6 publications

(5 citation statements)

References 8 publications

(9 reference statements)

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“…Accordingly, infection of cells with the coronavirus IBV has been shown to disrupt nucleolar architecture ( Dove et al, 2006b ), and cause arrest of the cell cycle ( Dove et al, 2006a ). Infection with SARS-CoV-2 virus resulted in multinucleated cells with prominent nucleoli ( Draeger et al, 2022 ; Xia et al, 2022 ). RNA viruses interact with the nucleolus to usurp host-cell functions and recruit nucleolar proteins to facilitate viral replication ( Hiscox, 2007 ; Rawlinson and Moseley, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Nucleolin mediates SARS-CoV-2 replication and viral-induced apoptosis of host cells

Merino

Ordoñez

et al. 2023

Antiviral Research

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Section: Discussionmentioning

confidence: 99%

Nucleolin mediates SARS-CoV-2 replication and viral-induced apoptosis of host cells

Merino

Ordoñez

et al. 2023

Antiviral Research

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“…Viral upper respiratory tract infections are believed to play an important role in causing acute exacerbations of airway obstruction [ 6 ]. Pathological results suggest that SARS-CoV-2 may be directly responsible for tracheal stenosis [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Fatal Asphyxia Potentially Caused by COVID-19-Induced Exacerbation of Pre-existing Tracheal Stenosis

Kuwahara¹,

Otagaki²,

Imanaka³

2023

Cureus

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We report a case of cardiac arrest due to asphyxia caused by coronavirus disease 2019 (COVID-19) in a patient with no history of tracheal intubation but with a history of subglottic stenosis. A 54-year-old man suffered a cardiac arrest at home. The patient had tracheal stenosis; therefore, it was difficult to intubate. The patient had COVID-19, which was presumed to have aggravated the existing tracheal stenosis and caused asphyxiation. The patient died seven days later. This is, to our knowledge, the first report of a patient with subglottic stenosis potentially aggravated by COVID-19, resulting in asphyxia-related cardiopulmonary arrest. The patient could not be saved, but emergency physicians should be aware that airway obstruction can be caused by viral infections, including severe acute respiratory syndrome coronavirus 2 infections. Physicians should consider the difficulty in performing oral intubation and cricothyrotomy and be aware of alternative methods to secure the airway.

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“…It is difficult to conclude that COVID-19 infection causes direct tracheal injury, as many of the findings associated with COVID-19 are also implicated in the development of TS, such as the presence of airway infection, or the need for EI and PDT. However, there is one case series that histologically examines subglottic tissue samples in patients with known TS after COVID-19 infection, and found them to have multinucleated syncytial cells with prominent nucleoli, a histological finding specific to SARS-CoV-2 infection [ 14 ]. This may suggest that COVID-19 is an independent risk factor in the development of TS, but research on this topic is limited.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Dilemma: A Patient With Pulmonary Fibrosis Who Presented for Severe Tracheal Stenosis After COVID-19 Pneumonia

Hubbell¹,

Aslam²,

Khalil³

et al. 2023

Cureus

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A 44-year-old man with pulmonary fibrosis presented to our pulmonary hypertension clinic with biphasic stridor and dyspnea. He was sent to the emergency department, where he was found to have 90% subglottic tracheal stenosis and was successfully treated with balloon dilation. Seven months prior to the presentation, herequired intubation for coronavirus disease 2019 (COVID-19) pneumonia complicated by hemorrhagic stroke. He was discharged after percutaneous dilatational tracheostomy, which was decannulated after three months.Our patient possessed several risk factors for tracheal stenosis, including endotracheal intubation, tracheostomy, and airway infection. Furthermore, our case is of great importance given the developing literature on COVID-19 pneumonia and its subsequent complications. Additionally, his history of interstitial lung disease may have confounded his presentation. Therefore, it is important to understand stridor, as it is an important exam finding that clinically distinguishes upper and lower airway disease. Our patient's biphasic stridor is consistent with the diagnosis of severe tracheal stenosis.

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Histologic evidence of tracheal stenosis directly resulting from SARS-CoV-2 tissue infiltration, a case series

Cited by 6 publications

References 8 publications

Nucleolin mediates SARS-CoV-2 replication and viral-induced apoptosis of host cells

Nucleolin mediates SARS-CoV-2 replication and viral-induced apoptosis of host cells

Fatal Asphyxia Potentially Caused by COVID-19-Induced Exacerbation of Pre-existing Tracheal Stenosis

Diagnostic Dilemma: A Patient With Pulmonary Fibrosis Who Presented for Severe Tracheal Stenosis After COVID-19 Pneumonia

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