RT Journal Article
SR Electronic
T1 Pulmonary stromal expansion and intra-alveolar coagulation are primary causes of Covid-19 death
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 2020.12.23.424172
DO 10.1101/2020.12.23.424172
A1 Laszlo Szekely
A1 Bela Bozoky
A1 Matyas Bendek
A1 Masih Ostad
A1 Pablo Lavignasse
A1 Lars Haag
A1 Jieyu Wu
A1 Xu Jing
A1 Soham Gupta
A1 Elisa Saccon
A1 Anders Sönnerborg
A1 Yihai Cao
A1 Mikael Björnstedt
A1 Attila Szakos
YR 2020
UL http://biorxiv.org/content/early/2020/12/26/2020.12.23.424172.abstract
AB 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.Competing Interest StatementThe authors have declared no competing interest.