Pathological changes in the lungs and lymphatic organs of 12 COVID-19 autopsy cases

被引：54

作者：

Liu, Qian ^{[1
]}

Shi, Yu ^{[2
,3
]}

Cai, Jun ^{[4
]}

Duan, Yaqi ^{[5
,6
]}

Wang, Rongshuai ^{[7
]}

Zhang, Hongyan ^{[8
]}

Ruan, Qiurong ^{[5
,6
]}

Li, Jiansha ^{[5
,6
]}

Zhao, Lei ^{[4
]}

Ping, Yifang ^{[2
,3
]}

Chen, Rong ^{[9
]}

Ren, Liang ^{[1
]}

Fei, Xiaochun ^{[10
]}

Zhang, Heng ^{[10
]}

Tang, Rui ^{[2
,3
]}

Wang, Xi ^{[5
,6
]}

Luo, Tao ^{[2
,3
]}

Liu, Xindong ^{[2
,3
]}

Huang, Xuequan ^{[11
]}

Liu, Zhenhua ^{[10
]}

Ao, Qilin ^{[5
,6
]}

Ren, Yong ^{[12
]}

Xiong, Jing ^{[5
]}

He, Zhicheng ^{[2
,3
]}

Wu, Haibo ^{[13
]}

Fu, Wenjuan ^{[2
,3
]}

Zhao, Pengnan ^{[8
]}

Chen, Xinwei ^{[12
]}

Qu, Guoqiang ^{[7
]}

Wang, Yunyun ^{[1
]}

Liu, Jia ^{[14
]}

Xiang, Dongfang ^{[2
,3
]}

Xu, Sanpeng ^{[5
]}

Zhou, Xiaowei ^{[7
]}

Li, Qingrui ^{[2
,3
]}

Ma, Jinghong ^{[7
]}

Li, Heng ^{[13
]}

Zhang, Jie ^{[1
]}

Huang, Sizhe ^{[1
]}

Yao, Xiaohong ^{[2
,3
]}

Zhou, Yiwu ^{[1
]}

Wang, Chaofu ^{[10
]}

Zhang, Dingyu ^{[15
,16
,17
]}

Wang, Guoping ^{[5
,6
]}

Liu, Liang ^{[1
]}

Bian, Xiu-Wu ^{[2
,3
]}

机构：

[1] Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Forens Med, Wuhan 430030, Peoples R China

[2] Third Mil Med Univ, Army Med Univ, Inst Pathol, Southwest Hosp, Chongqing 400038, Peoples R China

[3] Minist Educ China, Key Lab Tumor Immunopathol, Chongqing 400038, Peoples R China

[4] Shanghai Jiao Tong Univ, Dept Pathol, Sch Med, Shanghai 200025, Peoples R China

[5] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Inst Pathol, Wuhan 430030, Peoples R China

[6] Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Pathol, Wuhan 430030, Peoples R China

[7] Hubei Chongxin Judicial Expertise Ctr, Wuhan 430415, Peoples R China

[8] Third Mil Med Univ, Army Med Univ, Southwest Hosp, Chongqing 400038, Peoples R China

[9] Wuhan Jinyintan Hosp, Dept Pathol, Wuhan 430023, Peoples R China

[10] Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Pathol, Sch Med, Shanghai 200025, Peoples R China

[11] Third Mil Med Univ, Army Med Univ, Dept Vasc Surg, Southwest Hosp, Chongqing 400038, Peoples R China

[12] Gen Hosp Cent Theater Command PLA, Dept Pathol, Wuhan 430070, Peoples R China

[13] Univ Sci & Technol China, Affiliated Hosp USTC 1, Dept Pathol, Div Life Sci & Med, Hefei 230036, Peoples R China

[14] Chinese Acad Sci, Ctr Biosafety Megasci, Wuhan Inst Virol, State Key Lab Virol, Wuhan 430071, Peoples R China

[15] Wuhan Jinyintan Hosp, Res Ctr Translat Med, Wuhan 430023, Peoples R China

[16] Chinese Acad Sci, Wuhan Inst Virol, Joint Lab Infect Dis & Hlth, Wuhan 430023, Peoples R China

[17] Chinese Acad Sci, Wuhan Jinyintan Hosp, Wuhan 430023, Peoples R China

来源：

NATIONAL SCIENCE REVIEW | 2020年 / 7卷 / 12期

关键词：

COVID-19; SARS-CoV-2; autopsy; histopathology; immune disorder; CORONAVIRUS; PNEUMONIA;

D O I：

10.1093/nsr/nwaa247

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Systematic autopsy and comprehensive pathological analyses of COVID-19 decedents should provide insights into the disease characteristics and facilitate the development of novel therapeutics. In this study, we report the autopsy findings from the lungs and lymphatic organs of 12 COVID-19 decedents findings that evaluated histopathological changes, immune cell signature and inflammatory factor expression in the lungs, spleen and lymph nodes. Here we show that the major pulmonary alterations included diffuse alveolar damage, interstitial fibrosis and exudative inflammation featured with extensive serous and fibrin exudates, macrophage infiltration and abundant production of inflammatory factors (IL-6, IP-10, TNF alpha and IL-1 beta). The spleen and hilar lymph nodes contained lesions with tissue structure disruption and immune cell dysregulation, including lymphopenia and macrophage accumulation. These findings provide pathological evidence that links injuries of the lungs and lymphatic organs with the fatal systematic respiratory and immune malfunction in critically ill COVID-19 patients.

引用

页码：1868 / 1878

页数：11

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