Pulmonary Vascular Injury May Explain Some Features of COVID-19 Lung Disease

Three autopsy series describe the histologic characteristics of COVID-19 severe lung disease, including widespread pulmonary arterial thrombosis possibly caused by endothelial infection with SARS-CoV-2.

Thrombotic disease has been widely observed in critically ill COVID-19 patients, and reports have described both pulmonary arterial thrombosis and venous clot leading to pulmonary emboli (J Am Coll Cardiol 2020; [e-pub]). Now, three autopsy reports further describe the pathological changes observed in the lungs of these patients.

The first two reports describe findings in a total of 21 patients with COVID-19. Diffuse alveolar damage (DAD) at various stages was observed in all patients. An unexpected finding in all 11 patients reported by Lax and colleagues was frequent, grossly visible thrombosis of small and mid-sized pulmonary arteries. Further, pulmonary infarction was noted in 8 patients. The authors suspect that the cause of death in th…

Reviewing Author

Daniel Kaul, MD

Disclosures

Grant/Research SupportNobelpharma; Pfizer

Leadership Positions in Professional SocietiesAmerican Society of Transplantation (Program Committee)

Daniel Kaul, MD

Disclosures

Grant/Research SupportNobelpharma; Pfizer

Leadership Positions in Professional SocietiesAmerican Society of Transplantation (Program Committee)

Pulmonary Vascular Injury May Explain Some Features of COVID-19 Lung Disease

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Reviewing Author