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Microscopical Findings in COVID-19: which Diversity?

Author: Karima Idrissi Serhrouchni, Jinane Kharmoum, Adil Najdi, Mariame Chraibi

Category: JMSR Pathology


Purpose: The main goal of this paper is to present a review study of the different publications reporting histopathological findings regarding SARS-COV-2 from the beginning of the epidemic till today in order to use the overall finding to clarify the pathogenesis. Methods: A literature review was carried out. Relevant papers were identified and Data related to general settings and pathological features of patients COVID-19 were extracted, classed and compared. Results: Seven publications were examined. Overall 80 patients COVID-19 underwent histopathological examination. There was a general predominance of males. Range of age mean (50 - 78.5). The features of the exudative and proliferative phases of Diffuse Alveolar Disease (DAD) were noted in the diverse series: capillary congestion, necrosis of pneumocytes, hyaline membrane, interstitial edema, pneumocyte hyperplasia and reactive atypia. Although, thromboembolic events were as well reported in patients with COVID-19. Conclusion and perspectives: We try to understand the pathogenesis of SARS-COV-2 and the molecular events triggered by its binding to target organs receptors, mainly the lung. It will be probably the subject of new therapeutic methods.

Keywords: CoVID-19 pathogenicity, Diffuse alveolar damage, Microthrombi, SARS-CoV-2

DOI: 10.46327/msrjg.1.000000000000184



[1] Sufang T, Weidong H, Li Niu, Huan Liu, Haibo Xu, Shu-Yuan Xiao. Pulmonary pathology of early phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer. Journal of Thoracic Oncology.

[2] Zhe X, Lei S, Yijin W, Jiyuan Z, Lei H, Chao Z, Shuhong L, Peng Z, Hongxia L, Li Z, Yanhong T, Changqing B, Tingting G, Jinwen S, Peng X, Jinghui D, Jingmin Z, Fu SW. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Vol 8 April 2020

[3] Sufang T, Yong X, Huan L, Li N, Jianchun G, Meiyan L, Shu YX. Pathological study of the 2019 novel coronavirus disease (COVID-19) through post-mortem core biopsies. Modern Pathology 2020; doi:10.1038/s41379-020-0536-x

[4] Luca C, Aurelio S, Ahmed N, Roberta S, Alessandro P, Pietro Z, Roberto R, Riccardo C, Spinello A, Mario C, Massimo G, Emanuele C, Antonella T, Andrea G, Manuela N. Pulmonary post-mortem findings in a large series of COVID-19 cases from Northern Italy.

[5] Menter T, Haslbauer J.D, Nienhold R, Savic S, Hopfer H, Deigendesch N, Frank S, Turek D,

Willi N, Pargger H, Bassetti S, Leuppi JD, Cathomas G, Tolnay M, Mertz KD, Tzankov A. Post- mortem examination of COVID19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings of lungs and other organs suggesting vascular dysfunction. doi:10.1111/HIS.14134

[6] Lisa MB, Eric JD, Edana S, Subha G, Sanjay M. COVID-19 Autopsies, Oklahoma, USA. Am J Clin Pathol 2020;XX:1-9 2020 May 5;153(6):725-733.

[7] Wichmann D, Sperhake JP, Marc L, Stefan S, Carolin E, Axel H, Fabian H, Herbert M, Inga K, Ann S, Christoph B, Geraldine DH, Axel N, Daniel F, Susanne P, Heinrich B, Hanns BW, Andreas DW, Hans-Richard P, Sara SE, Axel S, Stefan S, Carsten B, Marylyn M, Martin A, Klaus P, Stefan K. Autopsy findings and venous thromboembolism in patients with COVID-19: a prospective cohort study. Ann Intern Med. 2020; Epub ahead of print. German COVID-19 Autopsy Data Show Thromboembolism, ‘Heavy’ Lungs

[8] Jia L, Xin Z, Qiaoxia T, Wei L, Baoju W, Kathrin S, Mirko T, Mengji L, Ulf D, Dongliang Y. Overlapping and discrete aspects of the pathology and pathogenesis of the emerging human pathogenic coronaviruses SARS?CoV, MERS?CoV, and 2019?nCoV. Journal of Medical virology DOI: 10.1002/jmv.25709.

[9] Aiping W, Yousong P, Baoying H, Xiao D, Xianyue W, Peihua N, Jing M, Zhaozhong Z, Zheng Z, Jiangyuan W, Jie S, Lijun Q, Zanxian X, Wenjie T, Genhong C, Taijiao J. Genome Composition and Divergence of the Novel Coronavirus (2019-nCoV) Originating in China. Cell Host Microbe 2020

[10] Xing-Y G, Jia-Lu L, Xing-Lou Y, Aleksei A, Guangjian Z, Jonathan H, Jonna K, Ben H, Wei Z, Cheng P, Yu-Ji Z, Chu-Ming L, Bing T, Ning W, Yan Z, Gary C, Shu-Yi Z, Lin-Fa W, Peter D, Zheng-Li S. Isolation and characterization of a bat SARS-like coronavirus that uses the ACE2 receptor. Nature 2013; 503(7477):535-538.

[11] Jun L, Jiwan G, Jinfang Y, Sisi S, Huan Z, Shilong F, Qi Z, Xuanling S, Qisheng W, Linqi Z, Xinquan W. Crystal structure of the 2019-nCoV spike receptor-binding domain bound with the ACE2 receptor. BioRxiv 2020

[12] Hao X, Liang Z, Jiaxin D, Jiakuan P, Hongxia D, Xin Z, Taiwen L, Qianming C. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. International Journal of Oral Science (2020) 12:8 ; 020-0074-x

[13] Xin Z, Ke C, Jiawei Z, Peiyi H, Jie H, Zeguang H. The single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to Wuhan 2019-nCoV infection. Front. Med. 10.1007/s11684-020-0754-0 (2020).

[14] Hao Z, Zijian K, Haiyi G, Da X, Jing W, Zifu L, Xingang C, Jianru X, Tong M, Wang Z, Jianmin L, Huji X. The digestive system is a potential route of 2019-nCov infection: a bioinformatics analysis based on single-cell transcriptomes. Preprint at https:// (2020).

[15] Xiaoqiang C, Longfei H, Yan Z, Weiyu H, Zhou L, Aiwu K, Jian Z, Guoming S, Nan F, Jia F, Jiabin C, Jue F, Fei L. Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. Preprint at 2020.02.03.931766v1 (2020).

[16] Hamming I, Timens W, Bulthuis MLC, Lely AT, Navis GJ, Van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol 2004; 203: 631–637. DOI: 10.1002/path.1570

[17] Abraham LK, Laura LT. HISTOLOGY AND CELL BIOLOGY. An Introduction to Pathology. Canada: Elsevier, 2016, 4th ed p. 429.

[18] Lau YL, Peiris JSM, Law HKW. Role of dendritic cells in SARS coronavirus infection. Hong Kong Med J 2012; 18 (Suppl 3):S28-30