Lung autopsies provide a clearer picture of how the SARS-CoV-2 virus spreads and causes damage

Autopsy and plasma samples from the lungs of people who died of COVID-19 have provided a clearer picture of how the SARS-CoV-2 virus spreads and damages lung tissue. Researchers at the National Institutes of Health and their associates say the data was released in Science in Translational Medicine, can help predict severe and prolonged cases of COVID-19, especially in high-risk people, and provide information on effective treatments.

Although the study was small – lung samples from 18 cases and plasma samples from six cases – the researchers say their data revealed trends that could help develop new COVID-19 drugs and fine-tune when existing drugs are used at different stages of the disease. progress. The findings include details of how the SARS-CoV-2 virus, which causes COVID-19, spreads to the lungs, manipulates the immune system, causes widespread thrombosis that does not improve, and targets signaling pathways that contribute to lung failure, fibrosis, and impairment. tissue repair. Researchers say the data is particularly important in treating COVID-19 patients who are elderly, obese or diabetic – all considered high-risk populations due to severe cases. The study samples were from patients with at least one high-risk disease.

The study included patients who died between March and July 2020, and the time from death ranged from three to 47 days after the onset of symptoms. This variable time frame allowed researchers to compare short-, medium-, and long-term cases. In each case, scattered lesions of the alveoli were observed, which prevent proper oxygen flow into the blood and eventually make the lungs thickened and stiff.

They also found that SARS-CoV-2 directly infects basal epithelial cells in the lung and inhibited their essential function in repairing damaged airways and lungs and forming healthy tissue. The process is different from the way influenza viruses attack lung cells. This will give researchers more information they can use when evaluating or developing antiviral drugs.

Researchers at the NIH’s National Institute of Allergy and Infectious Diseases led the project in collaboration with the National Institute of Biomedical Imaging and Bioengineering and the U.S. Food and Drug Administration. Other partners included the Seattle-based Institute for Systems Biology; University of Illinois, Champaign; Saint John’s Cancer Institute in Santa Monica, California .; USC Keck School of Medicine in Los Angeles; University of Washington Harborview Medical Center, Seattle; University of Vermont Medical Center, Burlington; and the Memorial Sloan Kettering Cancer Center in New York.


National Institutes of Health

Journal reference:

D’Agnillo, F., et al. (2021) Lung epithelial and endothelial damage, loss of tissue repair, inhibition of fibrinolysis, and cell aging in fatal COVID-19. Science of Translational Medicine.


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