Abstract
An ongoing pandemic of coronavirus disease (COVID-19) is caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Characterization of the histopathology and cellular localization of SARS-CoV-2 in the tissues of patients with fatal COVID-19 is critical to further understand its pathogenesis and transmission and for public health prevention measures. We report clinicopathologic, immunohistochemical, and electron microscopic findings in tissues from 8 fatal laboratory-confirmed cases of SARS-CoV-2 infection in the United States. All cases except 1 were in residents of long-term care facilities. In these patients, SARS-CoV-2 infected epithelium of the upper and lower airways with diffuse alveolar damage as the predominant pulmonary pathology. SARS-CoV-2 was detectable by immunohistochemistry and electron microscopy in conducting airways, pneumocytes, alveolar macrophages, and a hilar lymph node but was not identified in other extrapulmonary tissues. Respiratory viral co-infections were identified in 3 cases; 3 cases had evidence of bacterial co-infection.
Highlights
An ongoing pandemic of coronavirus disease (COVID-19) is caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
The current knowledge about COVID-19 pathogenesis and pathology in fatalities is based on a small number of described cases and extrapolations from what is known about other similar coronaviruses, such as SARS-CoV and MERSCoV [10,11,12,13,14,15,16,17,18]
We report on the histopathologic features and detection of virus in tissues by immunohistochemistry (IHC) and electron microscopy (EM) from 8 confirmed fatal cases of COVID-19 in the United States
Summary
An ongoing pandemic of coronavirus disease (COVID-19) is caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). All cases except 1 were in residents of long-term care facilities In these patients, SARS-CoV-2 infected epithelium of the upper and lower airways with diffuse alveolar damage as the predominant pulmonary pathology. The current knowledge about COVID-19 pathogenesis and pathology in fatalities is based on a small number of described cases and extrapolations from what is known about other similar coronaviruses, such as SARS-CoV and MERSCoV [10,11,12,13,14,15,16,17,18]. We report on the histopathologic features and detection of virus in tissues by immunohistochemistry (IHC) and electron microscopy (EM) from 8 confirmed fatal cases of COVID-19 in the United States
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