scholarly journals The pulmonary pathology of COVID-19

2021 ◽  
Vol 478 (1) ◽  
pp. 137-150
Author(s):  
Hans Bösmüller ◽  
Matthias Matter ◽  
Falko Fend ◽  
Alexandar Tzankov
Keyword(s):  
Viral Infections ◽  
Diffuse Alveolar Damage ◽  
High Viral Load ◽  
Lung Damage ◽  
Disease Stage ◽  
Lung Pathology ◽  
Open Questions ◽  
Cytokine Levels ◽  
Novel Coronavirus ◽  
Disease Stages

AbstractThe lung is the main affected organ in severe coronavirus disease 2019 (COVID-19) caused by the novel coronavirus SARS-CoV-2, and lung damage is the leading cause of death in the vast majority of patients. Mainly based on results obtained by autopsies, the seminal features of fatal COVID-19 have been described by many groups worldwide. Early changes encompass edema, epithelial damage, and capillaritis/endothelialitis, frequently combined with microthrombosis. Subsequently, patients with manifest respiratory insufficiency exhibit exudative diffuse alveolar damage (DAD) with hyaline membrane formation and pneumocyte type 2 hyperplasia, variably complicated by superinfection, which may progress to organizing/fibrotic stage DAD. These features, however, are not specific for COVID-19 and can be found in other disorders including viral infections. Clinically, the early disease stage of severe COVID-19 is characterized by high viral load, lymphopenia, massive secretion of pro-inflammatory cytokines and hypercoagulability, documented by elevated D-dimers and an increased frequency of thrombotic and thromboembolic events, whereas virus loads and cytokine levels tend to decrease in late disease stages, when tissue repair including angiogenesis prevails. The present review describes the spectrum of lung pathology based on the current literature and the authors’ personal experience derived from clinical autopsies, and tries to summarize our current understanding and open questions of the pathophysiology of severe pulmonary COVID-19.

scholarly journals Sphingolipids in Lung Pathology in the Coronavirus Disease Era: A Review of Sphingolipid Involvement in the Pathogenesis of Lung Damage

2021 ◽  
Vol 12 ◽  
Author(s):  
Saad A. Khan ◽  
Kayla F. Goliwas ◽  
Jessy S. Deshane
Keyword(s):  
De Novo ◽  
Therapeutic Option ◽  
Treatment Options ◽  
Lung Damage ◽  
Lung Pathology ◽  
Cytokine Storm ◽  
Bioactive Lipids ◽  
Chronic Lung Diseases ◽  
Sphingosine 1 Phosphate ◽  
Novel Coronavirus

Sphingolipids are bioactive lipids involved in the regulation of cell survival, proliferation, and the inflammatory response. The SphK/S1P/S1PR pathway (S1P pathway) is a driver of many anti-apoptotic and proliferative processes. Pro-survival sphingolipid sphingosine-1-phosphate (S1P) initiates its signaling cascade by interacting with various sphingosine-1-phosphate receptors (S1PR) through which it is able to exert its pro-survival or inflammatory effects. Whereas sphingolipids, including ceramides and sphingosines are pro-apoptotic. The pro-apoptotic lipid, ceramide, can be produced de novo by ceramide synthases and converted to sphingosine by way of ceramidases. The balance of these antagonistic lipids and how this balance manifests is the essence of the sphingolipid rheostat. Recent studies on SARS-CoV-2 have implicated the S1P pathway in the pathogenesis of novel coronavirus disease COVID-19-related lung damage. Accumulating evidence indicates that an aberrant inflammatory process, known as “cytokine storm” causes lung injury in COVID-19, and studies have shown that the S1P pathway is involved in signaling this hyperinflammatory response. Beyond the influence of this pathway on cytokine storm, over the last decade the S1P pathway has been investigated for its role in a wide array of lung pathologies, including pulmonary fibrosis, pulmonary arterial hypertension (PAH), and lung cancer. Various studies have used S1P pathway modulators in models of lung disease; many of these efforts have yielded results that point to the potential efficacy of targeting this pathway for future treatment options. Additionally, they have emphasized S1P pathway’s significant role in inflammation, fibrosis, and a number of other endothelial and epithelial changes that contribute to lung damage. This review summarizes the S1P pathway’s involvement in COVID-19 and chronic lung diseases and discusses the potential for targeting S1P pathway as a therapeutic option for these diseases.

scholarly journals Non-invasive ventilation in patients with novel coronavirus infection COVID-19

2020 ◽  
Vol 30 (5) ◽  
pp. 679-687
Author(s):  
Sergey N. Avdeev
Keyword(s):  
Viral Infections ◽  
Lung Damage ◽  
Protective Equipment ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Hypoxemic Acute Respiratory Failure ◽  
Coronavirus Infection ◽  
Novel Coronavirus ◽  
Support Methods

In the early stages of the COVID-19 pandemic, many guidelines for the management of patients with new coronavirus infection did not include recommendations for the use of non-invasive ventilation (NIV) due to the concerns that NIV could be accompanied by high tidal volumes that could cause lung damage. In addition, there was an opinion that NIV increases the risk of spreading bioaerosol containing the SARS-CoV-2 virus. At the same time, NIV was widely used in real clinical practice in the management of severe patients with COVID-19 (in some countries, up to 60% of all respiratory support methods). The accumulated experience demonstrates that when applying NIV, the risk of contamination with viral infections is minimized with adequate use of personal protective equipment. To date, the results of a limited number of studies about effectiveness of NIV in hypoxemic acute respiratory failure (ARF) in patients with COVID-19 are available. In most studies, the need for tracheal intubation and hospital mortality, were on average, 20 – 30%, that suggests a fairly high effectiveness of NIV in ARF in patients with COVID-19.

scholarly journals Morphological characteristic of coronavirus infection of the first and second waves of the pandemic

2021 ◽  
pp. 53-66
Author(s):  
A.P. Nadeev ◽  
◽  
D.V. Morozov ◽  
M.A. Travin ◽  
K.A. Nizovtsev ◽  
...  
Keyword(s):  
Diffuse Alveolar Damage ◽  
Lower Lobe ◽  
Diagnostic Methods ◽  
Lung Damage ◽  
Endocrine Disorders ◽  
The Novel ◽  
Treatment Regimens ◽  
Coronavirus Infection ◽  
Productive Phase ◽  
Novel Coronavirus

Introduction. A peculiarity of the first two waves of the epidemic of a novel coronavirus infection was that during their development only diagnostic methods, treatment regimens and anti-epidemic measures were only being developed, there were no vaccines and no mass vaccination was carried out. In this regard, the pandemic of the novel coronavirus infection of the first two waves is characterized by spontaneous progression of the disease. Aim of the research. Comparative study of morphological and clinical features of the novel coronavirus infection in the 1st and 2nd waves of the pandemic in 2020. Materials and methods. The autopsy protocols of deceased patients at the City Clinical Hospital No. 1 (Novosibirsk) during the 1st (May — June 2020) (1st group) and 2nd (October — December 2020) (2nd group) waves of the epidemic were analyzed. The 1st group included 30 cases, that is 14 women (46.7%) and 16 men (53.3%), in the 2nd — 110 cases, of which 43 were women (39.1%) and 67 – men (60.9%). In all cases, the presence of SARS-CoV-2 RNA in nasopharyngeal swabs from the patients was confirmed by polymerase chain reaction. Results. The novel coronavirus infection (coronavirus disease 2019 (COVID-19), ICD-10 code: U07.1) as the principal diagnosis in both the 1st and 2nd waves was recorded in more than 66% of observations. Among the comorbidities, the circulatory and endocrine disorders (primarily diabetes mellitus and obesity), kidneys and urinary tract diseases, mainly chronic pyelonephritis, prevailed. The COVID-19 pneumonia was predominantly bilateral polysegmental serоhemorrhagic in nature, however, in the 1st wave of the pandemic, the frequency of subtotal and seropurulent pneumonias was higher than in patients hospitalized during the 2nd wave. Diffuse alveolar damage in the 1st wave of the epidemic was characterized by the predominance of the early (exudative) phase of inflammation, in contrast to the 2nd wave, which was characterized by the predominance of the late (productive) phase in patients. Histologically, in patients of the 1st wave, the signs of exudative inflammation and hemorrhagic phenomena (with neutrophils and hyaline membranes in the alveoli, infarctions caused by thrombosis and pulmonary thromboembolism) prevailed. In the 2nd wave, signs of productive inflammation were more common in the lungs (predominance of macrophages in the alveoli, organizing pneumonia (pneumofibrosis), squamous cell metaplasia). Conclusion. The differences in the course of the novel coronavirus infection in the 1st and 2nd waves of the 2020 epidemic concerned primarily the frequency and structure of comorbidities and the level of polymorbidity, which were higher in patients during the 2nd wave. The severity of lung damage in patients of the 2nd wave was less pronounced: subtotal bilateral pneumonias were less common, lower lobe seropurulent pneumonias were more common. Diffuse alveolar damage in the 1st wave of the epidemic was characterized by the predominance of the early (exudative) phase, in contrast to the 2nd wave, which was characterized by the predominance of the late, productive phase of inflammation.

scholarly journals Pneumothorax Following COVID-19: Based on Autopsy Findings

2021 ◽  
Author(s):  
Rongshuai Wang ◽  
Rong Chen ◽  
Sanpeng Xu ◽  
Guoqiang Qu ◽  
Yunyun Wang ◽  
...  
Keyword(s):  
Causes Of Death ◽  
Diffuse Alveolar Damage ◽  
Chest Ct ◽  
Lung Pathology ◽  
Ct Image ◽  
Fatal Complication ◽  
X Ray ◽  
Autopsy Findings ◽  
Autopsy Examination ◽  
Novel Coronavirus

Abstract Background More and more studies showed pneumothorax is a complication of the 2019 novel coronavirus disease (COVID-19). But no autopsy findings of pneumothorax in COVID-19 decedent were reported, and direct relations between pneumothorax and lung pathology in these decedents were not discussed so far.Methods A 62-year-old man with COVID-19 presenting with persistent hypoxemia and suddenly dead, who was treated by mechanical ventilation in the intensive care unit (ICU) for 5 days. A systemic autopsy examination of COVID-19 decedent, including histopathology study, was conducted and the medical record, chest computerized tomography (CT) image were reviewed by forensic pathologists and clinicians. Results Severe pneumothorax, diffuse alveolar damage and airway obstruction were observed. Pneumothorax should be one of the causes of death.Conclusion Pneumothorax, due to SARS-CoV-2 infection, is a fatal complication of COVID-19. Regular examination of chest CT or X-ray and airway management are important to clinical treatment.

The Beneficial Effects of QIAPI 1® against Pentavalent Arsenic-Induced Lung Toxicity a Hypothetical Model for SARS CoV2-Induced Lung Toxicity

2021 ◽  
Vol 22 ◽  
Author(s):  
Arturo Solís Herrera ◽  
Narasimha M. Beeraka ◽  
Mikhail Y Sinelnikov ◽  
Vladimir N. Nikolenko ◽  
Dimitry B. Giller ◽  
...  
Keyword(s):  
Influenza A ◽  
Viral Infections ◽  
Interstitial Fibrosis ◽  
Diffuse Alveolar Damage ◽  
Wistar Rat ◽  
Lung Toxicity ◽  
Control Group ◽  
Lung Pathology ◽  
Environmental Toxicants ◽  
Hypothetical Model

: Exposure to environmental toxicants such as Arsenic (As) can result in As-induced alterations in immune regulators. Consequently, people who are more prone to viral infections like influenza A or B, H1N1, SARS CoV (Severe Acute Respiratory Syndrome Coronavirus), and SARS CoV2 may develop susceptibility to immune responses in their lungs because our previous reports delineated the ability of QIAPI 1®, a melanin precursor, to dissociate water molecules with simultaneous therapeutic efficacy against central nervous system (CNS) diseases, retinopathy, and As-induced renal toxicity. Given the commonalities of lung pathology of SARS CoV and As-induced toxicity, the aim of this study is to decipher the efficacy of QIAPI 1® against pentavalent As-induced lung toxicity by examining the pulmonary pathology. Hematoxylin & Eosin (H&E) staining was used for ascertaining the lung pathology in Wistar rat models. Animals were divided into 3 groups: control group, group treated with pentavalent As, and a group treated with pentavalent As and QIAPI 1®. There were no significant changes in lung histopathology in the control group as indicated by intact morphology. As-treated group revealed damage to the histoarchitecture with pulmonary edema, interstitial fibrosis, diffuse alveolar damage, Bronchiolitis obliterans organizing pneumonia (BOOP)-lesions, formation of hyaline membrane, multinucleated giant pneumocytes, atypical pneumocytes, inflammatory cell infiltration, and interstitial edema. The group treated with As and QIAPI 1® significantly associated with mitigated histological signs of lung inflammation induced by Arsenic. Therefore, QIAPI 1® can be recommended as antagonistic to As-induced lung toxicity. In conclusion, this model could be preferred as a hypothetical model to examine the efficacy of QIAPI 1® in SARS CoV2-induced pulmonary damage. Future studies are warranted to delineate the efficacy of QIAPI 1® against SARS CoV and SARS CoV2 lung pathology.

scholarly journals Role of the C5a-C5a receptor axis in the inflammatory responses of the lungs after experimental polytrauma and hemorrhagic shock

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shinjini Chakraborty ◽  
Veronika Eva Winkelmann ◽  
Sonja Braumüller ◽  
Annette Palmer ◽  
Anke Schultze ◽  
...  
Keyword(s):  
Hemorrhagic Shock ◽  
Inflammatory Responses ◽  
Experimental Models ◽  
Lung Damage ◽  
C5a Receptor ◽  
Cytokine Levels ◽  
Vitro Model

AbstractSingular blockade of C5a in experimental models of sepsis is known to confer protection by rescuing lethality and decreasing pro-inflammatory responses. However, the role of inhibiting C5a has not been evaluated in the context of sterile systemic inflammatory responses, like polytrauma and hemorrhagic shock (PT + HS). In our presented study, a novel and highly specific C5a L-aptamer, NoxD21, was used to block C5a activity in an experimental murine model of PT + HS. The aim of the study was to assess early modulation of inflammatory responses and lung damage 4 h after PT + HS induction. NoxD21-treated PT + HS mice displayed greater polymorphonuclear cell recruitment in the lung, increased pro-inflammatory cytokine levels in the bronchoalveolar lavage fluids (BALF) and reduced myeloperoxidase levels within the lung tissue. An in vitro model of the alveolar-capillary barrier was established to confirm these in vivo observations. Treatment with a polytrauma cocktail induced barrier damage only after 16 h, and NoxD21 treatment in vitro did not rescue this effect. Furthermore, to test the exact role of both the cognate receptors of C5a (C5aR1 and C5aR2), experimental PT + HS was induced in C5aR1 knockout (C5aR1 KO) and C5aR2 KO mice. Following 4 h of PT + HS, C5aR2 KO mice had significantly reduced IL-6 and IL-17 levels in the BALF without significant lung damage, and both, C5aR1 KO and C5aR2 KO PT + HS animals displayed reduced MPO levels within the lungs. In conclusion, the C5aR2 could be a putative driver of early local inflammatory responses in the lung after PT + HS.

The roles of vitamin D in increasing the body's immunity and reducing injuries due to viral infections: With an emphasis on its possible role in SARS-CoV-2 (COVID-19)

2021 ◽  
Vol 27 ◽  
Author(s):  
Elahe Aleebrahim-Dehkordi ◽  
Niloofar Deravi ◽  
Shirin Yaghoobpoor ◽  
Dariush Hooshyar ◽  
Mahmoud Rafieian-Kopaei
Keyword(s):  
Vitamin D ◽  
Immune System ◽  
Vitamin D Deficiency ◽  
Viral Infections ◽  
Vitamin D Supplementation ◽  
Angiotensin Converting Enzyme 2 ◽  
Treatment And Prevention ◽  
Lung Injuries ◽  
Novel Coronavirus ◽  
Cytochrome P450 Family

Background: It is known that Vitamin D can increase the body’s immunity against some viral infections. Many people around the world have vitamin D deficiency and, therefore, this has become a public concern whether vitamin D is an important factor protecting against COVID-19 infection. In this paper, the data about the roles of vitamin D on immunity and recovery from viral infections, especially novel Coronavirus disease (COVID-19) is reviewed. Methods: The electronic databases of Pubmed, Google Scholar, Research Gate, Excerpta Media Database (EMBASE) and Medical and Health Education (Medrix) were searched. Results: Vitamin D is considered an important factor in immune homeostasis. Various effects have been considered for this nutrient on the immune system, particularly because of vitamin D receptor (VDR) and Cytochrome P450 Family 27 Subfamily B Member 1 (CYP27B1) expression in most of the immune cells. Vitamin D can raise cellular immunity, reduce cytokine storm and enhance antioxidants production. It also has modulatory effects on Angiotensin-converting enzyme 2 (ACE2) receptors and might have protective functions against acute lung injuries, including COVID-19 infection. However, there are some articles against this positive effect. Conclusion: Vitamin D supplementation is reported to be effective in the enhancement of the immune system and might be effective in the treatment and prevention of COVID-19 infection, especially in those with its deficiency. However, it should be considered that vitamin D deficiency shows the overall health status of the patients and cannot be considered specific for COVID-19 infection.

High cytokine levels and cytokine storm in the novel coronavirus infection

2021 ◽  
pp. 38-47
Author(s):  
Maksim Leonidovich Maksimov ◽  
Albina Ayratovna Zvegintseva ◽  
Lyudmila Yurievna Kulagina ◽  
Albina Zainutdinovna Nigmedzyanova ◽  
Elvina Ramisovna Kadyseva
Keyword(s):  
Peripheral Blood ◽  
High Frequency ◽  
The Novel ◽  
Cytokine Storm ◽  
The Public ◽  
Systemic Inflammatory Reaction ◽  
Scientific World ◽  
Cytokine Levels ◽  
Coronavirus Infection ◽  
Novel Coronavirus

A review article is based on current foreign sources. The level of cytokines in the peripheral blood can be increased in many diseases, but in some cases there may be an excess of their normal concentration in tens, hundreds or more times with the development of a peculiar clinical picture, which is based on a systemic inflammatory reaction. In the literature this condition has received the figurative name «cytokine storm», which highlights an extremely violent reaction of the immune system with an unknown (often unfavorable) outcome. Close attention of the scientific world and the public to the problem of extremely high levels of cytokines in the peripheral blood (hypercytokinemia) was drawn due to the high frequency of the cytokine storm in the novel coronavirus infection.

The Role of Spices with reference Novel Coronavirus Covid 19

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1655-1661
Author(s):  
Roshna Sukheoji Bhutada ◽  
Kritika Umate
Keyword(s):  
Viral Infections ◽  
The Body ◽  
Common People ◽  
Supplementary Food ◽  
Long Time ◽  
Novel Coronavirus ◽  
The Right ◽  
Common Spices ◽  
Physiological Reactions

The need of the day is a brisk lift to the resistant framework to keep it fit, battling today pandemic infections, for example, Covid — 19. One should get the right amount of nutrients from the diet, supplementation regimen to boost the immune system. These spices are always there to make tasty food as well as to protect the body from infectious diseases by building the immunity strong Ayurveda approaches to develop physiological reactions to facilitate immunity. Planning of diet is most important to boost immunity. As per many types of research to provide supplementary food which contains Zinc, Vitamin C, Vitamin D and immunity boosting food such as dealing with plenty of spices for a very long time. These spices include some rare to very common spices which we can found near us. The concern is that these viral infections are very prone to attack weak immunity and take the chance to affect the country to the globe. So the very common spices available will be always helpful to get through this Regular use of a few spices in the very simple form proves its importance as a medicine. In this article a review of spices is done which we are available near us, we are using it in our daily life and we are getting the benefit of these which a common people might not be fully aware of about role of immunity building of the body. 

Physical Exercise and Yoga: as an alternative approach towards COVID-19 management

2021 ◽  
Vol 07 ◽  
Author(s):  
Saurabh Kumar ◽  
Sakshi Sudha ◽  
Madhu Chopra ◽  
Famida Khan ◽  
Kanupriya Sharma
Keyword(s):  
Physical Exercise ◽  
Literature Search ◽  
Viral Infections ◽  
Cost Effective ◽  
Mental Wellbeing ◽  
World Population ◽  
Cd8 Cells ◽  
Global Pandemic ◽  
Potential Benefits ◽  
Novel Coronavirus

Background: Novel Coronavirus (COVID-19), a highly contagious ssRNA +Ve sense virus that emerged in late 2019, has created a global panic. With no effective therapy available, the virus has significantly affected the world population causing millions of death. Therefore, it is the utmost need to look towards all the possible strategies to benefit the community. Objectives: In view of the current global pandemic, we tried to discuss the potential benefits of two cost-effective alternative approaches, i.e., physical exercise and yoga. Method: The editorial is based on a literature search available on PubMed, Google Scholar, and WHO portal. Search terminologies include “yoga”, “physical exercise”, “COVID-19”, “viral infections”, and a combination of these words. Results: A literature search defines yoga and physical exercise efficacy in different viral diseases, including HIV, influenza, and HSV. It ameliorates the quality of life (QoL) by improving both the physical and mental wellbeing of an individual. This is mainly done by promoting the better functioning of the immune system (increases CD4+ and CD8+ cells and reduces pro-inflammatory response). Conclusions: Regular involvement of these activities in day-to-day life may limit latent virus reactivations and reduce infection chances.

Sign in / Sign up

Export Citation Format

Share Document