Pulmonary vascular proliferation in patients with severe COVID-19: an autopsy study.

Pérez-Mies, Belén; Gómez-Rojo, María; Carretero-Barrio, Irene; Bardi, Tommaso; Benito, Amparo; García-Cosío, Mónica; Caballero, Álvaro; de Pablo, Raul et al. · Thorax · 2021

other · Level V

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Abstract

Diffuse alveolar damage and thrombi are the most common lung histopathological lesions reported in patients with severe COVID-19. Although some studies have suggested increased pulmonary angiogenesis, the presence of vascular proliferation in COVID-19 lungs has not been well characterised. Glomeruloid-like microscopic foci and/or coalescent vascular proliferations measuring up to 2 cm were present in the lung of 14 out of 16 autopsied patients. These lesions expressed CD31, CD34 and vascular endothelial cadherin. Platelet-derived growth factor receptor-β immunohistochemistry and dual immunostaining for CD34/smooth muscle actin demonstrated the presence of pericytes. These vascular alterations may contribute to the severe and refractory hypoxaemia that is common in patients with severe COVID-19.

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