Earliest Histopathological Changes in COVID-19 Pneumonia with Comprehensive Gene Expression Analyses: A Case Series Study

Overview

Journal Histol Histopathol

Specialties Anatomy & Histology
Pathology

Date 2022 Dec 1

PMID 36453630

Authors

Koji Okudela

Hiroyuki Hayashi

Yukihiro Yoshimura

Hiroaki Sasaki

Nobuyuki Miyata

Hiromichi Iwashita

Toshiaki Kataoka

Mai Matsumura

Hideaki Mitsui

Yasuyoshi Hatayama

Tsuneo Yamashiro

Akihide Ryo

Natsuo Tachikawa

Affiliations

Soon will be listed here.

Abstract

Aims: In COVID-19 pneumonia, early detection and appropriate treatment are essential to prevent severe exacerbation. Therefore, it is important to understand the initiating events of COVID-19 pneumonia. However, at present, the literature about early stage disease has been very limited. Here, we investigated the earliest histopathological changes and gene expression profiles associated with COVID-19 pneumonia.

Methods And Results: We carefully examined 25 autopsied cases with different clinical courses. Dilation of capillaries and edematous thickening of the alveolar septa were found even in areas that macroscopically looked almost normal. Pneumocytes, histocytes/macrophages, and vascular endothelial cells were immunohistochemically positive for tissue factor, which is an important early responder to tissue injuries. Comprehensive gene expression analyses revealed that those lesions presented differential profiles compared to those of control lungs and were associated with a significant upregulation of the lysosomal pathway.

Conclusions: Alveolar capillary dilation and edematous thickening may be the earliest histopathological change detected in COVID-19 pneumonia. Intensive investigations of such lesions may lead to an understanding of the initiating event of not only COVID-19 pneumonia but also of general diffuse alveolar damage.

Citing Articles

Frequency of subclinical interstitial lung disease in COVID-19 autopsy cases: potential risk factors of severe pneumonia.

Iwashita H, Kawabata Y, Hayashi H, Matsushita S, Yamashiro T, Matsumura M BMC Pulm Med. 2023; 23(1):408.

PMID: 37891495 PMC: 10612296. DOI: 10.1186/s12890-023-02692-1.

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