Pathological findings and morphologic correlation of the lungs of autopsied patients with SARS-CoV-2 infection in the Brazilian Amazon using transmission electron microscopy

Abstract INTRODUCTION: Electron microscopy (EM) is a rapid and effective tool that can be used to create images of a whole spectrum of virus-host interactions and, as such, has long been used in the discovery and description of viral mechanisms. METHODS: Electron microscopy was used to evaluate the...

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Published in:Revista da Sociedade Brasileira de Medicina Tropical
Main Authors: Monique Freire Santana, Rebecca Augusta de Araújo Pinto, Bruna Hilzendeger Marcon, Lia Carolina Almeida Soares de Medeiros, Thiago Barros do Nascimento de Morais, Lucas Castanhola Dias, Lorenna Pereira de Souza, Gisely Cardoso de Melo, Wuelton Marcelo Monteiro, Marcus Vinicius Guimarães Lacerda, Fernando Almeida Val, Pritesh Jaychand Lalwani, Luiz Carlos de Lima Ferreira
Format: Article in Journal/Newspaper
Language:English
Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2021
Subjects:
Online Access:https://doi.org/10.1590/0037-8682-0850-2020
https://doaj.org/article/4ae0f58e00a640289b07cd8a8dc0391b
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spelling ftdoajarticles:oai:doaj.org/article:4ae0f58e00a640289b07cd8a8dc0391b 2023-05-15T15:12:59+02:00 Pathological findings and morphologic correlation of the lungs of autopsied patients with SARS-CoV-2 infection in the Brazilian Amazon using transmission electron microscopy Monique Freire Santana Rebecca Augusta de Araújo Pinto Bruna Hilzendeger Marcon Lia Carolina Almeida Soares de Medeiros Thiago Barros do Nascimento de Morais Lucas Castanhola Dias Lorenna Pereira de Souza Gisely Cardoso de Melo Wuelton Marcelo Monteiro Marcus Vinicius Guimarães Lacerda Fernando Almeida Val Pritesh Jaychand Lalwani Luiz Carlos de Lima Ferreira 2021-04-01T00:00:00Z https://doi.org/10.1590/0037-8682-0850-2020 https://doaj.org/article/4ae0f58e00a640289b07cd8a8dc0391b EN eng Sociedade Brasileira de Medicina Tropical (SBMT) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822021000100317&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0850-2020 https://doaj.org/article/4ae0f58e00a640289b07cd8a8dc0391b Revista da Sociedade Brasileira de Medicina Tropical, Vol 54 (2021) COVID-19 Severe acute respiratory syndrome 2 Lung pathology Electron microscopy Diffuse alveolar damage Postmortem evidence Arctic medicine. Tropical medicine RC955-962 article 2021 ftdoajarticles https://doi.org/10.1590/0037-8682-0850-2020 2022-12-30T23:24:18Z Abstract INTRODUCTION: Electron microscopy (EM) is a rapid and effective tool that can be used to create images of a whole spectrum of virus-host interactions and, as such, has long been used in the discovery and description of viral mechanisms. METHODS: Electron microscopy was used to evaluate the pulmonary pathologies of postmortem lung sections from three patients who died from infection with SARS-associated coronavirus 2 (SARS-CoV-2), a new member of the Coronaviridae family. RESULTS: Diffuse alveolar damage (DAD) was predominant in all three patients. The early exudative stage was characterized principally by edema and extravasation of red blood cells into the alveolar space with injury to the alveolar epithelial cells; this was followed by detachment, apoptosis, and necrosis of type I and II pneumocytes. The capillaries exhibited congestion, exposure of the basement membrane from denuded endothelial cells, platelet adhesion, fibrin thrombi, and rupture of the capillary walls. The proliferative stage was characterized by pronounced proliferation of type II alveolar pneumocytes and multinucleated giant cells. The cytopathic effect of SARS-CoV-2 was observed both in degenerated type II pneumocytes and freely circulating in the alveoli, with components from virions, macrophages, lymphocytes, and cellular debris. CONCLUSIONS: Viral particles consistent with the characteristics of SARS-CoV-2 were observed mainly in degenerated pneumocytes, in the endothelium, or freely circulating in the alveoli. In the final stage of illness, the alveolar spaces were replaced by fibrosis. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista da Sociedade Brasileira de Medicina Tropical 54
institution Open Polar
collection Directory of Open Access Journals: DOAJ Articles
op_collection_id ftdoajarticles
language English
topic COVID-19
Severe acute respiratory syndrome 2
Lung pathology
Electron microscopy
Diffuse alveolar damage
Postmortem evidence
Arctic medicine. Tropical medicine
RC955-962
spellingShingle COVID-19
Severe acute respiratory syndrome 2
Lung pathology
Electron microscopy
Diffuse alveolar damage
Postmortem evidence
Arctic medicine. Tropical medicine
RC955-962
Monique Freire Santana
Rebecca Augusta de Araújo Pinto
Bruna Hilzendeger Marcon
Lia Carolina Almeida Soares de Medeiros
Thiago Barros do Nascimento de Morais
Lucas Castanhola Dias
Lorenna Pereira de Souza
Gisely Cardoso de Melo
Wuelton Marcelo Monteiro
Marcus Vinicius Guimarães Lacerda
Fernando Almeida Val
Pritesh Jaychand Lalwani
Luiz Carlos de Lima Ferreira
Pathological findings and morphologic correlation of the lungs of autopsied patients with SARS-CoV-2 infection in the Brazilian Amazon using transmission electron microscopy
topic_facet COVID-19
Severe acute respiratory syndrome 2
Lung pathology
Electron microscopy
Diffuse alveolar damage
Postmortem evidence
Arctic medicine. Tropical medicine
RC955-962
description Abstract INTRODUCTION: Electron microscopy (EM) is a rapid and effective tool that can be used to create images of a whole spectrum of virus-host interactions and, as such, has long been used in the discovery and description of viral mechanisms. METHODS: Electron microscopy was used to evaluate the pulmonary pathologies of postmortem lung sections from three patients who died from infection with SARS-associated coronavirus 2 (SARS-CoV-2), a new member of the Coronaviridae family. RESULTS: Diffuse alveolar damage (DAD) was predominant in all three patients. The early exudative stage was characterized principally by edema and extravasation of red blood cells into the alveolar space with injury to the alveolar epithelial cells; this was followed by detachment, apoptosis, and necrosis of type I and II pneumocytes. The capillaries exhibited congestion, exposure of the basement membrane from denuded endothelial cells, platelet adhesion, fibrin thrombi, and rupture of the capillary walls. The proliferative stage was characterized by pronounced proliferation of type II alveolar pneumocytes and multinucleated giant cells. The cytopathic effect of SARS-CoV-2 was observed both in degenerated type II pneumocytes and freely circulating in the alveoli, with components from virions, macrophages, lymphocytes, and cellular debris. CONCLUSIONS: Viral particles consistent with the characteristics of SARS-CoV-2 were observed mainly in degenerated pneumocytes, in the endothelium, or freely circulating in the alveoli. In the final stage of illness, the alveolar spaces were replaced by fibrosis.
format Article in Journal/Newspaper
author Monique Freire Santana
Rebecca Augusta de Araújo Pinto
Bruna Hilzendeger Marcon
Lia Carolina Almeida Soares de Medeiros
Thiago Barros do Nascimento de Morais
Lucas Castanhola Dias
Lorenna Pereira de Souza
Gisely Cardoso de Melo
Wuelton Marcelo Monteiro
Marcus Vinicius Guimarães Lacerda
Fernando Almeida Val
Pritesh Jaychand Lalwani
Luiz Carlos de Lima Ferreira
author_facet Monique Freire Santana
Rebecca Augusta de Araújo Pinto
Bruna Hilzendeger Marcon
Lia Carolina Almeida Soares de Medeiros
Thiago Barros do Nascimento de Morais
Lucas Castanhola Dias
Lorenna Pereira de Souza
Gisely Cardoso de Melo
Wuelton Marcelo Monteiro
Marcus Vinicius Guimarães Lacerda
Fernando Almeida Val
Pritesh Jaychand Lalwani
Luiz Carlos de Lima Ferreira
author_sort Monique Freire Santana
title Pathological findings and morphologic correlation of the lungs of autopsied patients with SARS-CoV-2 infection in the Brazilian Amazon using transmission electron microscopy
title_short Pathological findings and morphologic correlation of the lungs of autopsied patients with SARS-CoV-2 infection in the Brazilian Amazon using transmission electron microscopy
title_full Pathological findings and morphologic correlation of the lungs of autopsied patients with SARS-CoV-2 infection in the Brazilian Amazon using transmission electron microscopy
title_fullStr Pathological findings and morphologic correlation of the lungs of autopsied patients with SARS-CoV-2 infection in the Brazilian Amazon using transmission electron microscopy
title_full_unstemmed Pathological findings and morphologic correlation of the lungs of autopsied patients with SARS-CoV-2 infection in the Brazilian Amazon using transmission electron microscopy
title_sort pathological findings and morphologic correlation of the lungs of autopsied patients with sars-cov-2 infection in the brazilian amazon using transmission electron microscopy
publisher Sociedade Brasileira de Medicina Tropical (SBMT)
publishDate 2021
url https://doi.org/10.1590/0037-8682-0850-2020
https://doaj.org/article/4ae0f58e00a640289b07cd8a8dc0391b
geographic Arctic
geographic_facet Arctic
genre Arctic
genre_facet Arctic
op_source Revista da Sociedade Brasileira de Medicina Tropical, Vol 54 (2021)
op_relation http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822021000100317&tlng=en
https://doaj.org/toc/1678-9849
1678-9849
doi:10.1590/0037-8682-0850-2020
https://doaj.org/article/4ae0f58e00a640289b07cd8a8dc0391b
op_doi https://doi.org/10.1590/0037-8682-0850-2020
container_title Revista da Sociedade Brasileira de Medicina Tropical
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