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Pulmonary stromal expansion and intra-alveolar coagulation are primary causes of Covid-19 death
bioRxiv - Pathology Pub Date : 2020-12-26 , DOI: 10.1101/2020.12.23.424172
Laszlo Szekely , Bela Bozoky , Matyas Bendek , Masih Ostad , Pablo Lavignasse , Lars Haag , Jieyu Wu , Xu Jing , Soham Gupta , Elisa Saccon , Anders Sönnerborg , Yihai Cao , Mikael Björnstedt , Attila Szakos

Most Covid-19 victims are old and die from unrelated causes. Here we present twelve complete autopsies, including two rapid autopsies of young patients where the cause of death was Covid-19 ARDS. The main virus induced pathology was in the lung parenchyma and not in the airways. Most coagulation events occurred in the intra-alveolar and not in the intra-vascular space and the few thrombi were mainly composed of aggregated thrombocytes. The dominant inflammatory response was the massive accumulation of CD163+ macrophages and the disappearance of T killer, NK and B-cells. The virus was replicating in the pneumocytes and macrophages but not in bronchial epithelium, endothel, pericytes or stromal cells. The lung consolidations were produced by a massive regenerative response, stromal and epithelial proliferation and neovascularization. We suggest that thrombocyte aggregation inhibition, angiogenesis inhibition and general proliferation inhibition may have a roll in the treatment of advanced Covid-19 ARDS.

中文翻译:

肺间质扩张和肺泡内凝血是Covid-19死亡的主要原因

大多数Covid-19受害者都是年老的,死于无关的原因。在这里,我们提供十二份完整的尸体解剖资料,包括对年轻患者的两次快速尸体解剖,其中死因是Covid-19 ARDS。病毒引起的主要病理是在肺实质中,而不是在气道中。凝血事件多数发生在肺泡内,而不发生在血管内,少数血栓主要由聚集的血小板细胞组成。主要的炎症反应是CD163 +巨噬细胞的大量积累和T杀手,NK和B细胞的消失。该病毒在肺细胞和巨噬细胞中复制,但不在支气管上皮,内皮,周细胞或基质细胞中复制。大量的再生反应,基质和上皮细胞增殖以及新血管形成产生了肺部固结。
更新日期:2020-12-26
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