Pathological Lung Patterns of COVID-19 and its Clinical Correlation to Disease Severity

Abstract

A bstract Introduction Coronavirus disease-2019 (COVID-19) infection can result in pulmonary complications ranging from mild illness to severe life-threatening disease. There are limited studies correlating the association between the clinical course of COVID-19 and histopathological findings. This study aimed to examine the postmortem histopathological changes in lung tissue of COVID-19-positive patients and to correlate those changes with disease severity. Materials and methods This prospective observational study was conducted in adult COVID-19-positive patients. Postmortem core needle biopsy (CNB) of the lung was done using ultrasonography guidance within 1 hour of death. Histopathological analyses were performed by two expert pulmonary pathologists. The demographic and clinical data of the patients were recorded to correlate them with histopathological findings. Results In total, 48 patients were assessed for inclusion, and 21 patient relatives consented for the study. The median duration of illness was 21 (range 9–38) days, the predominant histopathological finding was diffuse alveolar damage (DAD) in most patients (19/21), followed by pneumonia (13/21). Exudative, intermediate, and advanced DAD patterns were seen in 9.5%, 52.4%, and 28.6% of cases, respectively. Advanced DAD was associated with a longer duration of disease. The pneumonia findings were associated with positive respiratory and blood cultures. The microvascular thrombus was seen only in one patient. Conclusion The predominant pathological findings in our patients were DAD and pneumonia. The DAD type correlated with the duration of illness, and we attributed pneumonia findings to secondary infection. The incidence of microvascular thrombi was low, and it might reflect the effect of treatment with anticoagulation. How to cite this article Maddani SS, Rao R, Deepa HC, Noronha AK, Chaudhuri S, Vishwas P. Pathological Lung Patterns of COVID-19 and its Clinical Correlation to Disease Severity. Indian J Crit Care Med 2022;26(12):1285–1292.

Spatiotemporal analysis of SARS-CoV-2 infection reveals an expansive wave of monocyte-derived macrophages associated with vascular damage and virus clearance in hamster lungs

“…The Golden Syrian hamster is generally accepted as a suitable model for the moderate COVID-19 pathogenesis in humans. However, the time course of infection in hamsters is within 7 days, which is distinctly shorter than in humans, where a medium duration of 21 days has been reported ( 40 ). Since the pathology found in hamsters resembles that found in COVID-19 patients, we considered this an ideal model to analyze the spatiotemporal disease progression and antiviral defense in this model.…”

Spatiotemporal analysis of SARS-CoV-2 infection reveals an expansive wave of monocyte-derived macrophages associated with vascular damage and virus clearance in hamster lungs

“…The Golden Syrian hamster is generally accepted as a suitable model for the moderate COVID-19 pathogenesis in humans. However, the time course of infection in hamsters is within 7 days, which is distinctly shorter than in humans, where a medium duration of 21 days has been reported [40]. Since the pathology found in hamsters resembles that found in COVID-19 patients, we considered this an ideal model to analyse the spatiotemporal disease progression and antiviral defence in this model.…”