Lungs’ Microscopic Patterns of Vessels in Patients Deceased with or by SARS-CoV-2 Infection

Abstract

Background: even if specific mechanisms are not completely understood, several studies highlighted SevereAcute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) ability to alter vascular homeostasis. In theliterature, multiple reports of microscopic pulmonary findings of vascular structures in patients deceased byor with SARS-Cov-2 infection are available. Nevertheless, the scientific literature lacks a systematic analysisof these findings. Methods: the authors realized a systematic review of the literature in order to identifycommon microscopic patterns representative of pulmonary vascular damage: useful data for pathologists inclinical and forensic settings. The research yielded 23 articles (79 total cases). Quali/quantitative analysiswas carried out. Conclusion: the review allowed to identify vascular thrombosis (especially in lesser calibervessels) as common microscopic pattern. The recurrence of this pattern was confirmed by scientific literaturedata which demonstrate SARS-CoV-2 ability to interfere with coagulation cascade. Other meaningfulmicroscopic findings were also discussed, even if their low frequency in study population did not allow todefine them as common.