Lesions in the lungs of fatal corona virus disease Covid-19

Colya N Englisch; Thomas Tschernig; Fidelis Flockerzi; Carola Meier; Rainer M Bohle

doi:10.1016/j.aanat.2020.151657

Lesions in the lungs of fatal corona virus disease Covid-19

Ann Anat. 2021 Mar:234:151657. doi: 10.1016/j.aanat.2020.151657. Epub 2020 Dec 3.

Authors

Colya N Englisch¹, Thomas Tschernig², Fidelis Flockerzi³, Carola Meier¹, Rainer M Bohle³

Affiliations

¹ Institute of Anatomy and Cell Biology, Saarland University, Campus Homburg, Kirrberger Str., 66421 Homburg/Saar, Germany.
² Institute of Anatomy and Cell Biology, Saarland University, Campus Homburg, Kirrberger Str., 66421 Homburg/Saar, Germany. Electronic address: Thomas.Tschernig@uks.eu.
³ Institute of Pathology, Saarland University, Homburg/Saar, Germany.

Abstract

The corona virus outbreak in Wuhan, China, at the end of 2019 has rapidly evolved into a pandemic which is still virulent in many countries. An infection with SARS-CoV-2 can lead to corona virus disease (Covid-19). This paper presents an overview of the knowledge gained so far with regard to histopathological lung lesions in fatal courses of Covid-19. The main findings were diffuse alveolar damage and micro-angiopathies. These included the development of hyaline membranes, thrombi, endothelial inflammation, haemorrhages and angiogenesis. Overall, the vessel lesions seemed to be more lethal than the diffuse alveolar damage. There was obvious hyperreactivity and hyperinflammation of the cellular immune system. An expanded T-cell memory may explain the increased risk of a severe course in the elderly.

Keywords: Angiogenesis; Covid-19; Diffuse alveolar damage; Hyaline membranes; Lung lesions; Pathology; Perivascular inflammation; SARS-CoV-2; Thrombi.

Publication types

Review

MeSH terms

Autopsy
COVID-19 / mortality
COVID-19 / pathology*
Humans
Lung / pathology*
Lung / virology
Pulmonary Alveoli / pathology
Pulmonary Alveoli / virology
SARS-CoV-2 / isolation & purification*