Fibrotic progression and radiologic correlation in matched lung samples from COVID-19 post-mortems.
Fibrotic progression and radiologic correlation in matched lung samples from COVID-19 post-mortems.
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COVID-19尸检匹配肺样本中的纤维化进展和放射学相关性。
DOI：
10.1007/s00428-020-02934-1
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Fiocca R
中科院分区：
文献类型：
--
作者：
Barisione E;Grillo F;Ball L;Bianchi R;Grosso M;Morbini P;Pelosi P;Patroniti NA;De Lucia A;Orengo G;Gratarola A;Verda M;Cittadini G;Mastracci L;Fiocca R
关于COVID-19病理学的数据很少;现有研究显示弥漫性肺泡损伤;然而，关于COVID-19肺部病变的时间演变的信息很少。该研究的主要目的是通过使用死后经支气管肺冷冻活检方法来描述COVID-19中肺部病理变化的时间顺序。我们的第二个目的是将组织学发现与计算机断层扫描模式相关联。SARS-CoV-2阳性患者在插管和机械通气时死亡。该程序在死亡后30分钟进行，并对所有肺叶进行采样。对来自8名患者的39个适当样本进行组织学分析：2名患者（病程< 14天）显示早期/渗出期弥漫性肺泡损伤，而其余6名患者（中位病程-32天）显示进行性组织学模式（3名为中期/增殖期; 3名为晚期/纤维化期弥漫性肺泡损伤，其中1名为蜂窝状）。SARS-CoV-2核衣壳蛋白免疫组化主要在早期病变中呈阳性。组织学模式和断层扫描分类相关：早期/渗出期与毛玻璃样阴影相关，中期/增生性病变与疯狂铺路相关，而晚期/纤维期与实变模式相关，更常见于下/中叶。这项研究使用了一种创新的冷冻活检方法，对COVID-19患者的肺组织进行尸检取样，证明了纤维化的时间进展以及与计算机断层扫描特征的相关性。这些发现可能有助于疾病的正确分期，这可能对治疗和患者随访产生影响。
Data on the pathology of COVID-19 are scarce; available studies show diffuse alveolar damage; however, there is scarce information on the chronologic evolution of COVID-19 lung lesions. The primary aim of the study is to describe the chronology of lung pathologic changes in COVID-19 by using a post-mortem transbronchial lung cryobiopsy approach. Our secondary aim is to correlate the histologic findings with computed tomography patterns. SARS-CoV-2-positive patients, who died while intubated and mechanically ventilated, were enrolled. The procedure was performed 30 min after death, and all lung lobes sampled. Histopathologic analysis was performed on thirty-nine adequate samples from eight patients: two patients (illness duration < 14 days) showed early/exudative phase diffuse alveolar damage, while the remaining 6 patients (median illness duration—32 days) showed progressive histologic patterns (3 with mid/proliferative phase; 3 with late/fibrotic phase diffuse alveolar damage, one of which with honeycombing). Immunohistochemistry for SARS-CoV-2 nucleocapsid protein was positive predominantly in early-phase lesions. Histologic patterns and tomography categories were correlated: early/exudative phase was associated with ground-glass opacity, mid/proliferative lesions with crazy paving, while late/fibrous phase correlated with the consolidation pattern, more frequently seen in the lower/middle lobes. This study uses an innovative cryobiopsy approach for the post-mortem sampling of lung tissues from COVID-19 patients demonstrating the progression of fibrosis in time and correlation with computed tomography features. These findings may prove to be useful in the correct staging of disease, and this could have implications for treatment and patient follow-up.
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DOI：
10.1016/j.ajpath.2015.10.024
发表时间：
2016-03
期刊：
The American journal of pathology
影响因子：
--
作者：
Ng DL;Al Hosani F;Keating MK;Gerber SI;Jones TL;Metcalfe MG;Tong S;Tao Y;Alami NN;Haynes LM;Mutei MA;Abdel-Wareth L;Uyeki TM;Swerdlow DL;Barakat M;Zaki SR
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Zaki SR
影响因子：
168.9
作者：
Huang, Chaolin;Wang, Yeming;Cao, Bin
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Cao, Bin
影响因子：
158.5
作者：
Ackermann, Maximilian;Verleden, Stijn E.;Jonigk, Danny
通讯作者：
Jonigk, Danny
DOI：
10.1016/s0140-6736(03)13413-7
发表时间：
2003-05-24
期刊：
Lancet (London, England)
影响因子：
--
作者：
Nicholls JM;Poon LL;Lee KC;Ng WF;Lai ST;Leung CY;Chu CM;Hui PK;Mak KL;Lim W;Yan KW;Chan KH;Tsang NC;Guan Y;Yuen KY;Peiris JS
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Peiris JS
影响因子：
76.2
作者：
Thille, Arnaud W.;Esteban, Andres;Frutos-Vivar, Fernando
通讯作者：
Frutos-Vivar, Fernando