Issue
A comprehensive review of histopathological findings of infections induced by COVID-19
Corresponding Author(s) : Fariba Tabari
Cellular and Molecular Biology,
Vol. 66 No. 7: Issue 7
Abstract
The severe acute respiratory syndrome (SARS)-Coronavirus (CoV2) virus, first identified in Wuhan, China, caused the coronavirus disease 2019 (COVID-19) which soon became a global pandemic, as labelled by the World Health Organization (WHO). The transmission method of the infection is primarily through droplets of various sizes. The SARS-CoV2 virus leads to a severe respiratory illness which in the first place causes the simulation of the acute respiratory syndrome. In order to diagnose of COVID-19 efficiently, samples with infection probability need to be examined through histopathological methods. Survival chances of the infected can remarkably increase if the virus is diagnosed timely by reverse transcription-polymerase chain reaction (RT-PCR) or computed tomography (CT) scan of the chest. One of the destructive effects of COVID-19 is the formation of ground-glass opacity (GGO) in the lungs which might be regarded to be equivalent to high-altitude pulmonary edema (HAPE). COVID-19 acts very similarly to SARS and Middle East Respiratory Syndrome (MERS) which can be inactivated by the chemical compounds of ethanol and sodium hypochlorite. Epidemiologic characteristics of COVID-19 have been indicated by numerous studies; however, there is still a lack of details of pathologic changes in the lung. The present comprehensive review is an attempt to assess and cover the current state of knowledge on COVID-19 disease based on the histopathologic studies conducted before May 2020.
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- Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2019; 382:727–733. DOI:10.1056/NEJMoa2001017.
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- Perlman S. Another decade, another coronavirus. N Engl J Med. 2020; 382:760–762.
- Guarner J. Three emerging Coronaviruses in two decades the story of SARS, MERS, and now COVID-19. Editorial Am J Clin Pathol. 2020; DOI:10.1093/AJCP/AQAA029.
- Gorbalenya A. E. Severe acute respiratory syndrome-related coronavirus–The species and its viruses, a statement of the Coronavirus Study Group. bioRxiv. 2020; Jan 1.
- World Health Organization (WHO). Coronavirus disease (COVID-2019) situation reports. 131. 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports.
- Wu Z, McGoogan J. M. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA.2020, Available from: https://jamanetwork.com/journals/jama/fullarticle/2762130.
- Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA. 2020; Available from: https://jamanetwork.com/journals/jama/fullarticle/2762997.
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- Tian S, Hu W, Niu L, Liu H, Xu H, Xiao S-Y. Pulmonary Pathology of Early-Phase 2019 Novel Coronavirus (COVID-19) Pneumonia in Two Patients with Lung Cancer. J Thorac Oncol. 2020. Available from: https://www.jto.org/article/S1556-0864(20)30132-5/abstract.
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- Menter T, Haslbauer J. D, Nienhold R, et al. Post-mortem examination of COVID19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings of lungs and other organs suggesting vascular dysfunction. Histopathol 2020; his.14134; Epub ahead of print. DOI: 10.1111/his.14134.
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- Sufang T, Yong X, Huan L, et al. Pathological study of the 2019 novel coronavirus disease (COVID-19) through post-mortem core biopsies. Modern Pathol 2020; doi:10.1038/s41379-020-0536-x.
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- Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med. 2020; [cited 2020 Mar 29];0(0). Available from: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/abstract.
- Elena C, Carmine V, Annibale A. P. COVID-19 Infection and Circulating ACE2 Levels: Protective Role in Women and Children. OPINION. 2020; doi: 10.3389/fped.2020.00206.
- Amita J. COVID-19 and lung pathology. Indian J Pathol Microbiol. 2020; 63:171-2. http://www.ijpmonline.org/text.asp?2020/63/2/171/282688.
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- Zhang C, Shi L, Wang F. S. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol. 2020; 5:428–30.
- Zhou J, Chu H, Li C, et al. Active replication of Middle East respiratory syndrome coronavirus and aberrant induction of inflammatory cytokines and chemokines in human macrophages: implications for pathogenesis. J Infect Dis. 2014; 209:1331-1342.
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- Wang R, Zhang X, Irwin DM, Shen Y. Emergence of SARS-like coronavirus poses new challenge in China. J Infect 2020; 80:350e371.
- Reusken C, Broberg E. K, Haagmans B, et al. Laboratory readiness and response for novel coronavirus (2019-nCoV) in expert laboratories in 30 EU/EEA countries, January 2020; Euro Surveill. 2020;25. https://doi.org/10.2807/1560-7917.ES.2020.25.6.2000082.
- Winichakoon P, Chaiwarith R, Liwsrisakun C, et al. Negative nasopharyngeal and oropharyngeal swab does not rule out COVID-19. J Clin Microbiol; 2020; https://doi.org/10.1128/JCM.00297-20.
- David S. C. H, Paul K. S. C. Severe Acute Respiratory Syndrome and Coronavirus. Infect Dis Clin N Am 24. 2010; 619–638.
- Fan Z, C L, Li J, Tian C, Zhang Y, Huang S, Liu Z, Cheng J. Clinical Features of COVID-19-Related Liver Functional Abnormality. Clin Gastroenterol Hepatol. 2020; 18(7):1561-1566. doi: 10.1016/j.cgh.2020.04.002.
- Cai Q, Deliang H, Hong Y, et al. Characteristics of Liver Tests in COVID-19 Patients. J Hepatol 2020; DOI: 10.1016/j.jhep.2020.04.006.
References
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Perlman S. Another decade, another coronavirus. N Engl J Med. 2020; 382:760–762.
Guarner J. Three emerging Coronaviruses in two decades the story of SARS, MERS, and now COVID-19. Editorial Am J Clin Pathol. 2020; DOI:10.1093/AJCP/AQAA029.
Gorbalenya A. E. Severe acute respiratory syndrome-related coronavirus–The species and its viruses, a statement of the Coronavirus Study Group. bioRxiv. 2020; Jan 1.
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Barton L. M, Duval E. J, Stroberg E, Ghosh S, Mukhopadhyay S. COVID-19 Autopsies, Oklahoma, USA. Am J Clin Pathol. 2020; 153:725–33.
Menter T, Haslbauer J. D, Nienhold R, et al. Post-mortem examination of COVID19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings of lungs and other organs suggesting vascular dysfunction. Histopathol 2020; his.14134; Epub ahead of print. DOI: 10.1111/his.14134.
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Iwen P. C, Stiles K. L, Pentella M. A. Safety considerations in the laboratory testing of specimens suspected or known to contain the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Am J Clin Pathol; 2020; https://doi.org/10.1093/ajcp/aqaa047. In press.
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Kuster G. M, Pfister O, Burkard T, et al. SARS-CoV2: should inhibitors of the renin-angiotensin system be withdrawn in patients with COVID-19? Eur Heart J. 2020; 41(19):1801-1803. doi: 10.1093/eurheartj/ehaa235.
Sufang T, Yong X, Huan L, et al. Pathological study of the 2019 novel coronavirus disease (COVID-19) through post-mortem core biopsies. Modern Pathol 2020; doi:10.1038/s41379-020-0536-x.
Huilan Z, Peng Z, Yanqiu W, Huihui Y, et al. Histopathologic Changes and SARS-CoV-2 Immunostaining in the Lung of a Patient with COVID-19. Ann Intern Med American College of Physicians. 2020; 172(9, 5).
Zhou P, Yang X. L, Wang X. G, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020; [PMID: 32015507] doi:10.1038/s41586-020-2012-7.
Corman V. M, Landt O, Kaiser M, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020; 25. [PMID: 31992387] doi:10.2807/1560-7917.ES.2020.25.3.2000045.
Rodriguez-Morales A. J, Cardona-Ospina J. A, Gutierrez-Ocampo E, et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis 2020;101623.
Benjamin T. Bradley, Heather Maioli, Robert Johnston, et al. Histopathology and Ultrastructural Findings of Fatal COVID-19 Infections. Cold Spring Harbor Laboratory. 2020; Doi: https://doi.org/10.1101/2020.04.17.20058545.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020; 323(11):1061.
Krishna S, Paul A. I. Dangers of ACE inhibitor and ARB usage in COVID-19: evaluating the evidence. Clinic Pharmacol Therapeutic 2020; DOI: 10.1002/cpt.1863.
Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med. 2020; [cited 2020 Mar 29];0(0). Available from: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/abstract.
Elena C, Carmine V, Annibale A. P. COVID-19 Infection and Circulating ACE2 Levels: Protective Role in Women and Children. OPINION. 2020; doi: 10.3389/fped.2020.00206.
Amita J. COVID-19 and lung pathology. Indian J Pathol Microbiol. 2020; 63:171-2. http://www.ijpmonline.org/text.asp?2020/63/2/171/282688.
Martines R. B, Ritter J. M, Matkovic E, Gary J, Bollweg BC, Bullock H, et al.; COVID-19 Pathology Working Group. Pathology and pathogenesis of fatal COVID-19 cases associated with SARS-CoV-2 pandemic. Emerg Infect Dis. 2020; https://doi.org/10.3201/eid2609.202095.
Kevin K, Montserrat B, Ronald W. A. L, et al. Ultrastructural Characterization of Arterivirus Replication Structures: Reshaping the Endoplasmic Reticulum to Accommodate Viral RNA Synthesis. J Virolog 2020; p. 2474–2487. Doi:10.1128/JVI.06677-11.
Kimball A, Hatfield KM, Arons M, James A, Taylor J, Spicer K, et al.; Public Health–Seattle & King County; CDC COVID-19 Investigation Team. Asymptomatic and presymptomatic SARS-CoV-2 infections in residents of a long-term care skilled nursing facility”King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep. 2020; 69:377–81.
Arons M. M, Hatfield K. M, Reddy S. C, Kimball A, James A, Jacobs J. R, et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. N Engl J Med. 2020; NEJMoa2008457.
Luo Y, Trevathan E, Qian Z, Li Y, Li J, Xiao W, et al. Asymptomatic SARS-CoV-2 infection in household contacts of a healthcare provider, Wuhan, China. Emerg Infect Dis. 2020; 26.
Zhang C, Shi L, Wang F. S. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol. 2020; 5:428–30.
Zhou J, Chu H, Li C, et al. Active replication of Middle East respiratory syndrome coronavirus and aberrant induction of inflammatory cytokines and chemokines in human macrophages: implications for pathogenesis. J Infect Dis. 2014; 209:1331-1342.
Guan W. J, Ni Z. Y, Hu Y, Liang W. H, Ou C. Q, He J. X, et al.; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020; 382:1708–20. DOI: 10.1056/NEJMoa2002032.
Zhe X, Lei S, Yijin W, Jiyuan Z, et al. Pathological fndings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020; https://doi.org/10.1016/S2213-2600(20)30076-X.
Robert J. M. Pathogenesis of COVID-19 from a cell biology perspective. Eur Respir J. 2020; 55: 2000607. https://doi.org/10.1183/13993003.00607-2020.
Yu F, Du L, Ojcius DM, Pan C, Jiang S. Measures for diagnosing and treating infections by a novel coronavirus responsible for a pneumonia outbreak originating in Wuhan, China. microbes Infect 2020; 22: 74-79.
Wang R, Zhang X, Irwin DM, Shen Y. Emergence of SARS-like coronavirus poses new challenge in China. J Infect 2020; 80:350e371.
Reusken C, Broberg E. K, Haagmans B, et al. Laboratory readiness and response for novel coronavirus (2019-nCoV) in expert laboratories in 30 EU/EEA countries, January 2020; Euro Surveill. 2020;25. https://doi.org/10.2807/1560-7917.ES.2020.25.6.2000082.
Winichakoon P, Chaiwarith R, Liwsrisakun C, et al. Negative nasopharyngeal and oropharyngeal swab does not rule out COVID-19. J Clin Microbiol; 2020; https://doi.org/10.1128/JCM.00297-20.
David S. C. H, Paul K. S. C. Severe Acute Respiratory Syndrome and Coronavirus. Infect Dis Clin N Am 24. 2010; 619–638.
Fan Z, C L, Li J, Tian C, Zhang Y, Huang S, Liu Z, Cheng J. Clinical Features of COVID-19-Related Liver Functional Abnormality. Clin Gastroenterol Hepatol. 2020; 18(7):1561-1566. doi: 10.1016/j.cgh.2020.04.002.
Cai Q, Deliang H, Hong Y, et al. Characteristics of Liver Tests in COVID-19 Patients. J Hepatol 2020; DOI: 10.1016/j.jhep.2020.04.006.