The pulmonary pathology of COVID-19
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| Název: | The pulmonary pathology of COVID-19 |
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| Autoři: | Hans Bösmüller, Matthias Matter, Falko Fend, Alexandar Tzankov |
| Zdroj: | Virchows Arch |
| Informace o vydavateli: | Springer Science and Business Media LLC, 2021. |
| Rok vydání: | 2021 |
| Témata: | Review and Perspectives, 0301 basic medicine, 03 medical and health sciences, 0302 clinical medicine, Lung/pathology [MeSH], COVID-19, Thrombosis/pathology [MeSH], Annual review issues from Virchows Archiv, Humans [MeSH], COVID-19/complications [MeSH], COVID-19/pathology [MeSH], Pulmonary disease, Diffuse alveolar damage, Thrombosis/virology [MeSH], Autopsy, Lung/virology [MeSH], SARS-CoV-2, Autopsy [MeSH], Humans, Thrombosis, Lung, 3. Good health |
| Popis: | The lung is the main affected organ in severe coronavirus disease 2019 (COVID-19) caused by the novel coronavirus SARS-CoV-2, and lung damage is the leading cause of death in the vast majority of patients. Mainly based on results obtained by autopsies, the seminal features of fatal COVID-19 have been described by many groups worldwide. Early changes encompass edema, epithelial damage, and capillaritis/endothelialitis, frequently combined with microthrombosis. Subsequently, patients with manifest respiratory insufficiency exhibit exudative diffuse alveolar damage (DAD) with hyaline membrane formation and pneumocyte type 2 hyperplasia, variably complicated by superinfection, which may progress to organizing/fibrotic stage DAD. These features, however, are not specific for COVID-19 and can be found in other disorders including viral infections. Clinically, the early disease stage of severe COVID-19 is characterized by high viral load, lymphopenia, massive secretion of pro-inflammatory cytokines and hypercoagulability, documented by elevated D-dimers and an increased frequency of thrombotic and thromboembolic events, whereas virus loads and cytokine levels tend to decrease in late disease stages, when tissue repair including angiogenesis prevails. The present review describes the spectrum of lung pathology based on the current literature and the authors’ personal experience derived from clinical autopsies, and tries to summarize our current understanding and open questions of the pathophysiology of severe pulmonary COVID-19. |
| Druh dokumentu: | Article Other literature type |
| Jazyk: | English |
| ISSN: | 1432-2307 0945-6317 |
| DOI: | 10.1007/s00428-021-03053-1 |
| Přístupová URL adresa: | https://link.springer.com/content/pdf/10.1007/s00428-021-03053-1.pdf https://pubmed.ncbi.nlm.nih.gov/33604758 https://link.springer.com/content/pdf/10.1007/s00428-021-03053-1.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892326 https://www.scilit.net/article/7d5786f573a60184b59fa2b22450f3c7 https://link.springer.com/article/10.1007/s00428-021-03053-1 https://repository.publisso.de/resource/frl:6450050 |
| Rights: | CC BY |
| Přístupové číslo: | edsair.doi.dedup.....ad4e774a6faf98c13cc2babed006a9a5 |
| Databáze: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | The lung is the main affected organ in severe coronavirus disease 2019 (COVID-19) caused by the novel coronavirus SARS-CoV-2, and lung damage is the leading cause of death in the vast majority of patients. Mainly based on results obtained by autopsies, the seminal features of fatal COVID-19 have been described by many groups worldwide. Early changes encompass edema, epithelial damage, and capillaritis/endothelialitis, frequently combined with microthrombosis. Subsequently, patients with manifest respiratory insufficiency exhibit exudative diffuse alveolar damage (DAD) with hyaline membrane formation and pneumocyte type 2 hyperplasia, variably complicated by superinfection, which may progress to organizing/fibrotic stage DAD. These features, however, are not specific for COVID-19 and can be found in other disorders including viral infections. Clinically, the early disease stage of severe COVID-19 is characterized by high viral load, lymphopenia, massive secretion of pro-inflammatory cytokines and hypercoagulability, documented by elevated D-dimers and an increased frequency of thrombotic and thromboembolic events, whereas virus loads and cytokine levels tend to decrease in late disease stages, when tissue repair including angiogenesis prevails. The present review describes the spectrum of lung pathology based on the current literature and the authors’ personal experience derived from clinical autopsies, and tries to summarize our current understanding and open questions of the pathophysiology of severe pulmonary COVID-19. |
|---|---|
| ISSN: | 14322307 09456317 |
| DOI: | 10.1007/s00428-021-03053-1 |