Original scientific paper
https://doi.org/10.3325/cmj.2024.65.501
Lung long distance: histopathological changes in lung tissue after COVID-19 pneumonia
Grgur Salai
; Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia
*
Jasna Tekavec-Trkanjec
; Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia
Ivona Kovačević
; Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia
Čedna Tomasović-Lončarić
; Clinical Department of Pathology and Cytology, University Hospital Dubrava, Zagreb, Croatia
Arijana Pačić
; Clinical Department of Pathology and Cytology, University Hospital Dubrava, Zagreb, Croatia
Mirna Vergles
; Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia
Đivo Ljubičić
; Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia
Daria Cvetković-Kučić
; Clinical Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, Zagreb, Croatia
Ivica Lukšić
; School of Medicine, University of Zagreb, Zagreb, Croatia 5 University Hospital Dubrava, Zagreb, Croatia
Bruno Baršić
; Infectious Disease Service, University Hospital Dubrava
* Corresponding author.
Abstract
Aim To investigate histopathological changes in the lung
tissue of long-COVID patients.
Methods In this cross-sectional study, transbronchial lung
biopsy was performed in long-COVID patients with persisting symptoms and radiological abnormalities. Histopathologic analyses were performed by using hematoxylin-eosin, Martius, Scarlet and Blue, Movat’s, thyroid transcription
factor 1, CD34, and CD68 staining.
Results Adequate biopsy samples were obtained from
29/32 patients. The median (Q1-Q3) time from disease onset to biopsy was 13 (9-20) weeks. We observed several histopathologic patterns: DAD with vascular abnormalities
(VA) (n=8); VA with inflammatory pattern (n=4); inflammatory pattern (n=13), and fibrotic pattern (n=4). VA included capillary thrombi, dilated venules, and dissection of
small pulmonary arteries. DAD with VA was detected up to
the 9th week from the onset of disease; inflammatory pattern from the 8th to 28th week (4 patients with this pattern
biopsied in the 11th-13th week had accompanying VA);
and a predominantly fibrotic pattern was found at weeks
8, 10, 48, and 49.
Conclusion Our study observed a slow recovery of lung
tissue with long-lasting DAD and VA, likely followed by
interstitial inflammation or focal fibrosis. These findings
might be the underlying cause of the slow recovery of
long-COVID patients.
Keywords
Hrčak ID:
337270
URI
Publication date:
19.12.2024.
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