Fibrotic progression and radiologic correlation in matched lung samples from COVID-19 postmortems

By Barisione E, Grillo, Ball L, et al
Published September 28, 2020

Key Takeaways

Using a postmortem transbronchial lung cryobiopsy approach, researchers sought to delineate the chronology of lung pathologic changes in COVID-19. In addition, they correlated the histologic findings with computed tomography patterns. The procedure was performed 30 min after death of SARS-CoV-2-positive patients, who died while intubated and mechanically ventilated, and all lung lobes sampled. Thirty-nine adequate samples from eight patients was used for performing histopathologic analysis; two patients (illness duration < 14 days) exhibited early/exudative phase diffuse alveolar damage, while the remaining 6 patients (median illness duration—32 days) displayed progressive histologic patterns (3 with mid/proliferative phase; 3 with late/fibrotic phase diffuse alveolar damage, one of which with honeycombing). Correlation was observed between histologic patterns and tomography categories: early/exudative phase was associated with ground-glass opacity, mid/proliferative lesions with crazy paving, while late/fibrous phase correlated with the consolidation pattern, more frequently seen in the lower/middle lobes. In conclusion, the innovative cryobiopsy approach used for the postmortem sampling of lung tissues from COVID-19 patients revealed progression of fibrosis in time and association with computed tomography features.

Read the full article on Virchows Archiv.

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