tetano
Editor, Senior Moderator
Respir Physiol Neurobiol
. 2022 Nov 29;104000.
doi: 10.1016/j.resp.2022.104000. Online ahead of print.
Morphological and functional findings in COVID-19 lung disease as compared to Pneumonia, ARDS, and High-Altitude Pulmonary Edema
Gustavo R Zubieta-Calleja[SUP] 1 [/SUP], Natalia Zubieta-DeUrioste[SUP] 1 [/SUP], de Jesus MontelongoFelipe de Jesús Montelongo[SUP] 2 [/SUP], Manuel Gabriel Romo Sanchez[SUP] 2 [/SUP], Aurio Fajardo Campoverdi[SUP] 3 [/SUP], Patricia Rieken Macedo Rocco[SUP] 4 [/SUP], Denise Battaglini[SUP] 5 [/SUP], Lorenzo Ball[SUP] 6 [/SUP], Paolo Pelosi[SUP] 6 [/SUP]
Affiliations
Abstract
Coronavirus disease-2019 (COVID-19) may severely affect respiratory function and evolve to life-threatening hypoxia. The clinical experience led to the implementation of standardized protocols assuming similarity to severe acute respiratory syndrome (SARS-CoV-2). Understanding the histopathological and functional patterns is essential to better understand the pathophysiology of COVID-19 and then develop new therapeutic strategies. Epithelial and endothelial cell damage can result from the virus attack, thus leading to immune-mediated response. Pulmonary histopathological findings show the presence of Mallory bodies, alveolar coating cells with nuclear atypia, reactive pneumocytes, reparative fibrosis, intra-alveolar hemorrhage, moderate inflammatory infiltrates, micro-abscesses, microthrombus, hyaline membrane fragments, and emphysema-like lung areas. COVID-19 patients may present different respiratory stages from silent to critical hypoxemia, are associated with the degree of pulmonary parenchymal involvement, thus yielding alteration of ventilation and perfusion relationships. This review aims to: discuss the morphological (histopathological and radiological) and functional findings of COVID-19 compared to acute interstitial pneumonia, acute respiratory distress syndrome (ARDS), and high-altitude pulmonary edema (HAPE), four entities that share common clinical traits, but have peculiar pathophysiological features with potential implications to their clinical management.
Keywords: ARDS; COVID-19; HAPE; SARS-CoV-2; lung sequelae; viral pneumonia.
. 2022 Nov 29;104000.
doi: 10.1016/j.resp.2022.104000. Online ahead of print.
Morphological and functional findings in COVID-19 lung disease as compared to Pneumonia, ARDS, and High-Altitude Pulmonary Edema
Gustavo R Zubieta-Calleja[SUP] 1 [/SUP], Natalia Zubieta-DeUrioste[SUP] 1 [/SUP], de Jesus MontelongoFelipe de Jesús Montelongo[SUP] 2 [/SUP], Manuel Gabriel Romo Sanchez[SUP] 2 [/SUP], Aurio Fajardo Campoverdi[SUP] 3 [/SUP], Patricia Rieken Macedo Rocco[SUP] 4 [/SUP], Denise Battaglini[SUP] 5 [/SUP], Lorenzo Ball[SUP] 6 [/SUP], Paolo Pelosi[SUP] 6 [/SUP]
Affiliations
- PMID: 36460252
- DOI: 10.1016/j.resp.2022.104000
Abstract
Coronavirus disease-2019 (COVID-19) may severely affect respiratory function and evolve to life-threatening hypoxia. The clinical experience led to the implementation of standardized protocols assuming similarity to severe acute respiratory syndrome (SARS-CoV-2). Understanding the histopathological and functional patterns is essential to better understand the pathophysiology of COVID-19 and then develop new therapeutic strategies. Epithelial and endothelial cell damage can result from the virus attack, thus leading to immune-mediated response. Pulmonary histopathological findings show the presence of Mallory bodies, alveolar coating cells with nuclear atypia, reactive pneumocytes, reparative fibrosis, intra-alveolar hemorrhage, moderate inflammatory infiltrates, micro-abscesses, microthrombus, hyaline membrane fragments, and emphysema-like lung areas. COVID-19 patients may present different respiratory stages from silent to critical hypoxemia, are associated with the degree of pulmonary parenchymal involvement, thus yielding alteration of ventilation and perfusion relationships. This review aims to: discuss the morphological (histopathological and radiological) and functional findings of COVID-19 compared to acute interstitial pneumonia, acute respiratory distress syndrome (ARDS), and high-altitude pulmonary edema (HAPE), four entities that share common clinical traits, but have peculiar pathophysiological features with potential implications to their clinical management.
Keywords: ARDS; COVID-19; HAPE; SARS-CoV-2; lung sequelae; viral pneumonia.