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In situ detection of SARS-CoV-2 in lungs and airways of patients with COVID-19

Modern pathology, 2020-11, Vol.33 (11), p.2104-2114 [Peer Reviewed Journal]

2020 United States & Canadian Academy of Pathology ;The Author(s), under exclusive licence to United States & Canadian Academy of Pathology 2020. ;The Author(s), under exclusive licence to United States & Canadian Academy of Pathology 2020 ;ISSN: 0893-3952 ;EISSN: 1530-0285 ;DOI: 10.1038/s41379-020-0595-z ;PMID: 32561849

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Title:
In situ detection of SARS-CoV-2 in lungs and airways of patients with COVID-19
Author: Schaefer, Inga-Marie ; Padera, Robert F. ; Solomon, Isaac H. ; Kanjilal, Sanjat ; Hammer, Mark M. ; Hornick, Jason L. ; Sholl, Lynette M.
Subjects: Aged ; Alveoli ; Antibodies ; Autopsy ; Betacoronavirus - isolation & purification ; Coronavirus Infections - pathology ; Coronavirus Infections - virology ; Coronaviruses ; COVID-19 ; Endothelial cells ; Epithelial cells ; Epithelium ; Female ; Humans ; Infections ; Lungs ; Male ; Middle Aged ; Pandemics ; Pneumocytes ; Pneumonia, Viral - pathology ; Pneumonia, Viral - virology ; Polymerase chain reaction ; Public health ; Respiratory distress syndrome ; Respiratory System - pathology ; Respiratory System - virology ; Respiratory tract ; Reverse Transcriptase Polymerase Chain Reaction ; RNA-directed DNA polymerase ; SARS-CoV-2 ; Severe Acute Respiratory Syndrome - pathology ; Severe Acute Respiratory Syndrome - virology ; Severe acute respiratory syndrome coronavirus 2
Is Part Of: Modern pathology, 2020-11, Vol.33 (11), p.2104-2114
Description: Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has led to a global public health crisis. In elderly individuals and those with comorbidities, COVID-19 is associated with high mortality, frequently caused by acute respiratory distress syndrome. We examine in situ expression of SARS-CoV-2 in airways and lung obtained at autopsy of individuals with confirmed COVID-19 infection. Seven autopsy cases (male, N = 5; female, N = 2) with reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infection and a median age of 66 years (range, 50–77 years) were evaluated using a rabbit polyclonal antibody against SARS Nucleocapsid protein in correlation with clinical parameters. The median time from symptom onset to death was 9 days (range, 6–31 days), from hospitalization 7 days (range, 1–21 days), from positive RT-PCR 7 days (range, 0–18 days), and from intensive care unit admission defining onset of respiratory failure 3 days (range, 1–18 days). Chest imaging identified diffuse airspace disease in all patients corresponding to acute and (N = 5) or organizing (N = 2) diffuse alveolar damage (DAD) on histologic examination. Among five patients with acute-phase DAD (≤7 days from onset of respiratory failure), SARS-CoV-2 was detected in pulmonary pneumocytes and ciliated airway cells (N = 5), and in upper airway epithelium (N = 2). In two patients with organizing DAD (>14 days from onset of respiratory failure), no virus was detected in lungs or airways. No endothelial cell infection was observed. The findings suggest that SARS-CoV-2 infection of epithelial cells in lungs and airways of patients with COVID-19 who developed respiratory failure can be detected during the acute phase of lung injury and is absent in the organizing phase.
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0893-3952
EISSN: 1530-0285
DOI: 10.1038/s41379-020-0595-z
PMID: 32561849
Source: GFMER Free Medical Journals
MEDLINE
ProQuest Central

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In situ detection of SARS-CoV-2 in lungs and airways of patients with COVID-19

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