Journal Article

Lung histopathological findings in COVID-19 disease – a systematic review

Pannone, Giuseppe, Caponio, Vito Carlo Alberto, Cassano, Tommaso, Ramunno, Maria Antonietta, Muzio, Lorenzo Lo, Advani, Shailesh, Meccariello, Mario, Papagerakis, Silvana, Agostinone, Alessio, Pedicillo, Maria Carmela, Zhurakivska, Khrystyna, Troiano, Giuseppe, Bizzoca, Maria Eleonora, Buonaguro, Franco Maria, De Stefano, Ilenia Sara

2021

Overview

Since December 2019, the global burden of the COVID-19 pandemic has increased rapidly and has impacted nearly every country in the world, affecting those who are elderly or with underlying comorbidities or immunocompromised states. Aim of this systematic review is to summarize lung histopathological characteristics of COVID-19, not only for diagnostic purpose but also to evaluate changes that can reflect pathophysiological pathways that can inform clinicians of useful treatment strategies. We identified following histopathological changes among our patients:: hyaline membranes; endothelial cells/ interstitial cells involvement; alveolar cells, type I pneumocytes/ type II pneumocytes involvement; interstitial and/ or alveolar edema; evidence of hemorrhage, of inflammatory cells, evidence of microthrombi; evidence of fibrin deposition and of viral infection in the tissue samples. The scenario with proliferative cell desquamation is typical of Acute Respiratory Distress Syndrome (ARDS) that can be classified as diffuse alveolar damage (DAD) and not DAD-ARDS. The proposed pathological mechanism concerns the role of both innate and adaptive components of the immune system. COVID-19 lethal cases present themselves as a heterogeneous disease, characterized by the different simultaneous presence of different histological findings, which reflect histological phases with corresponding different pathological pathways (epithelial, vascular and fibrotic changes), in the same patient.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acute respiratory distress syndrome / Alveoli / Biomedical and Life Sciences / Biomedicine / Cancer Research / Care and treatment / Clinical oncology / Comorbidity / Coronaviruses / COVID-19 / Disease / Edema / Endothelial cells / Epidemics / Fatalities / Fibrin / Health aspects / Hemorrhage / Histochemistry / Histopathology / Immune system / Infections / Infectious Diseases / Inflammation / Interstitial cells / Lung / Lungs / Medical research / Medicine, Experimental / Mutation / Oncology / Pandemics / Pathogens / Pneumocytes / Respiratory diseases / Respiratory distress syndrome / Review / Severe acute respiratory syndrome coronavirus 2 / Systematic review / Therapy / Tropical Medicine / Viral infections