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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