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1 . 2023

Clinical and morphological analysis of lung lesions with determination of cellular localization of SARS-CoV-2 virus proteins in lethal cases of COVID-19

Abstract

COVID-19 is a rapidly spreading viral disease caused by SARS-CoV-2 virus. In severe COVID-19, the main target organ is the lungs, in which various forms of damage develop, causing a different morphological picture in the respiratory system, clinical picture and prognosis in different patients in different waves.

The aim of the work is to analyze the cellular localization of SARS-CoV-2 virus proteins in various forms of lung damage in lethal cases of COVID-19.

Material and methods. A prospective study was performed on based of autopsies of 118 patients at the Kommunarka Medical Center using macroscopic and histological methods with immunohistochemical reactions. Antibodies against viral spike protein and nucleocapsid were used on paraffin sections of lung tissue. The resulting material was scanned into digital format and analyzed using morphometric techniques.

Results. In lung tissue of fatal COVID-19 patients diffuse alveolar damage and lymphocytic alveolitis may develop isolated or in combined. The secondary form was thrombovasculitis and bacterial pneumonia. In all examined cases, COVID-associated coagulopathy was detected. Viral proteins were determined with different intensity and frequency mainly in the cytoplasm of macrophages, type II pneumocytes and endotheliocytes in all forms of lung damage.

Conclusion. Various types of lung lesions can be independent forms and develop in isolation from each other. Viral proteins occur in the same cells with different frequency and intensity in different forms of lung damage, which may indicate possible common mechanisms of lung damage in COVID-19 and different ways the virus enters the lung tissue.

Keywords:coronavirus infection; COVID-19; lung pathology; SARS-CoV-2 viral proteins

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Zarubin E.A., Kogan E.A., Zharkov N.V., Avdalyan A.M., Protsenko D.N. Clinical and morphological analysis of lung lesions with determination of cellular localization of SARS-CoV-2 virus proteins in lethal cases of COVID-19. Clinical and Experimental Surgery. Petrovsky Journal. 2023; 11 (1): 54–63. DOI: https://doi.org/10.33029/2308-1198-2023-11-1-54-63  (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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