Pulmonary Parenchymal Changes in COVID-19 Survivors.
Pulmonary Parenchymal Changes in COVID-19 Survivors.
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DOI：
10.1016/j.athoracsur.2021.06.076
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发表时间：
2022-07
期刊：
影响因子：
--
通讯作者：
Abdelsattar ZM
中科院分区：
文献类型：
--
作者：
Diaz A;Bujnowski D;McMullen P;Lysandrou M;Ananthanarayanan V;Husain AN;Freeman R;Vigneswaran WT;Ferguson MK;Donington JS;Madariaga MLL;Abdelsattar ZM
随着COVID-19大流行进入生存阶段，有关长期肺损伤的问题仍未得到解答。以往的组织病理学研究仅限于尸检报告。我们研究了接受择期肺切除术的COVID-19幸存者的肺标本，以确定是否存在急性后组织病理学变化。这项多中心观察性研究纳入了11名成年COVID-19幸存者，他们已经康复，但随后因不确定的肺结节或肺癌接受了不相关的择期肺切除术。我们将这些与从未感染COVID-19的年龄和手术匹配的对照组（n = 5）和终末期COVID-19组（n = 3）进行了比较。设盲的肺病理学家检查了肺实质，重点是4个隔室：气道、肺泡、肺泡和血管。在COVID-19诊断后中位68.5天（范围24-142天），对11名无症状（n = 4）、中度（n = 4）和重度（n = 3）COVID-19感染的COVID-19幸存者进行了选择性肺切除术。最常见的手术是肺叶切除术（75%）。组织学检查发现，COVID-19幸存者和对照组的肺实质在检查的所有分区中均无差异。相反，终末期COVID-19组的患者表现出纤维化弥漫性肺泡损伤，肺泡内巨噬细胞，机化性肺炎和局灶性间质性肺气肿。在这项检查COVID-19幸存者肺实质的研究中，我们没有发现提示永久性肺损伤的明显急性后组织病理学变化。这些结果对于康复并变得无症状的COVID-19幸存者来说是令人放心的。
As the COVID-19 pandemic moves into the survivorship phase, questions regarding long-term lung damage remain unanswered. Previous histopathologic studies are limited to autopsy reports. We studied lung specimens from COVID-19 survivors who underwent elective lung resections to determine whether postacute histopathologic changes are present. This multicenter observational study included 11 adult COVID-19 survivors who had recovered but subsequently underwent unrelated elective lung resection for indeterminate lung nodules or lung cancer. We compared these against an age- and procedure-matched control group who never contracted COVID-19 (n = 5) and an end-stage COVID-19 group (n = 3). A blinded pulmonary pathologist examined the lung parenchyma focusing on 4 compartments: airways, alveoli, interstitium, and vasculature. Elective lung resection was performed in 11 COVID-19 survivors with asymptomatic (n = 4), moderate (n = 4), and severe (n = 3) COVID-19 infections at a median 68.5 days (range 24-142 days) after the COVID-19 diagnosis. The most common operation was lobectomy (75%). Histopathologic examination identified no differences between the lung parenchyma of COVID-19 survivors and controls across all compartments examined. Conversely, patients in the end-stage COVID-19 group showed fibrotic diffuse alveolar damage with intra-alveolar macrophages, organizing pneumonia, and focal interstitial emphysema. In this study to examine the lung parenchyma of COVID-19 survivors, we did not find distinct postacute histopathologic changes to suggest permanent pulmonary damage. These results are reassuring for COVID-19 survivors who recover and become asymptomatic.
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影响因子：
17.1
作者：
Bharat A;Querrey M;Markov NS;Kim S;Kurihara C;Garza-Castillon R;Manerikar A;Shilatifard A;Tomic R;Politanska Y;Abdala-Valencia H;Yeldandi AV;Lomasney JW;Misharin AV;Budinger GRS
通讯作者：
Budinger GRS
影响因子：
158.5
作者：
Ackermann, Maximilian;Verleden, Stijn E.;Jonigk, Danny
通讯作者：
Jonigk, Danny
影响因子：
10.7
作者：
COVIDSurg Collaborative;GlobalSurg Collaborative
通讯作者：
GlobalSurg Collaborative
影响因子：
5.5
作者：
Kligerman, Seth J.;Franks, Teri J.;Galvin, Jeffrey R.
通讯作者：
Galvin, Jeffrey R.
DOI：
10.1016/s1473-3099(20)30243-7
发表时间：
2020-06-01
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Verity, Robert;Okell, Lucy C;Ferguson, Neil M
通讯作者：
Ferguson, Neil M