COVID-Lung: The Battlefield (original) (raw)
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Respiratory Physiology & Neurobiology
Coronavirus disease-2019 (COVID-19) may severely affect respiratory function and evolve to life-threatening hypoxia. The clinical experience led to the implementation of standardized protocols assuming similarity to severe acute respiratory syndrome (SARS-CoV-2). Understanding the histopathological and functional patterns is essential to better understand the pathophysiology of COVID-19 and then develop new therapeutic strategies. Epithelial and endothelial cell damage can result from the virus attack, thus leading to immune-mediated response. Pulmonary histopathological findings show the presence of Mallory bodies, alveolar coating cells with nuclear atypia, reactive pneumocytes, reparative fibrosis, intra-alveolar hemorrhage, moderate inflammatory infiltrates, micro-abscesses, microthrombus, hyaline membrane fragments, and emphysema-like lung areas. COVID-19 patients may present different respiratory stages from silent to critical hypoxemia, are associated with the degree of pulmonary parenchymal involvement, thus yielding alteration of ventilation and perfusion relationships. This review aims to: discuss the morphological (histopathological and radiological) and functional findings of COVID-19 compared to acute interstitial pneumonia, acute respiratory distress syndrome (ARDS), and high-altitude pulmonary edema (HAPE), four entities that share common clinical traits, but have peculiar pathophysiological features with potential implications to their clinical management. Abbreviations: AIP, acute interstitial pneumonia; ARDS, acute respiratory distress syndrome; CO 2 , carbon dioxide; COVID-19, coronavirus disease 2019; CT, computed tomography; DAD, diffuse alveolar damage; DO 2 , oxygen delivery; ECCO 2 R, extracorporeal carbon dioxide removal; ECMO, extracorporeal membrane oxygenation; FiO 2 , fraction of inspired oxygen; HAPE, high altitude pulmonary edema; Hb, hemoglobin; HIF, hypoxia inducible factor; IIP, idiopathic interstitial pneumonia; LUS, lung ultrasound; MODS, multiple organ dysfunction; PaCO 2 , arterial partial pressure of carbon dioxide; PAO 2 , alveolar partial pressure of oxygen; PaO 2 , arterial partial pressure of oxygen; PEEP, positive end-expiratory pressure; SARS-CoV-2, severe acute respiratory syndrome coronavirus-2; SpO 2 , peripheral saturation of oxygen; V/Q, ventilation/ perfusion; VILI, ventilator-induced lung injury.
COVID-19: More Than A Lung Infection
2020
Shiha G1,2, *, Mousa N3, Abdel-Razik A3, Elhammady D3, Elshennawy H4, El-Farrash M5,6, Mousa E7, Taha A8, El-bendary M3 and Eslam M9 1Departments of Internal Medicine, Mansoura University, Egypt 2Egyptian Liver Research Institute and Hospital (ELRIH), Sherbin, Mansoura University, Egypt 3Departments of Tropical Medicine, Mansoura University, Egypt 4Departments of Internal Medicine, National Liver Institute, Egypt 5Department of Microbiology, Mansoura University, Egypt 6Horus University, Egypt 7Faculty of Dentistry, Mansoura University, Egypt 8Faculty of Medicine, October 6 University, Egypt 9Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, NSW, Australia
COVID-19: From viral infection to pulmonary failure
Journal of Clinical Images and Medical Case Reports, 2021
SARS-CoV-2 is a virus which promoted a worldwide pandemic outbreak in 2020. The virus is highly infectious and is able to contaminate a lot of people in a short time period. The disease promoted by the virus, named COVID-19, can cause different symptoms such as fever, cough, muscle pain, headache, prostration, diarrhea, neurological complications, dermic manifestations, pulmonary impairment, dyspnea, coagulopathies, organ failure, and death. Here, we show how the infection occurs and the major characteristics observed in the lungs of patients with COVID-19. In addition, we explored the immunological activation in this environment by the virus and some treatments used in the severe phase of the disease.
Current Oncology Reports
Purpose of Review Since the past year, the fast spread of coronavirus disease 2019 (COVID-19) has represented a global health threat, especially for cancer patients, that has required an urgent reorganization of clinical activities. Here, we will critically revise the profound impact that the pandemic has generated in lung cancer patients, as well the most significant challenges that oncologists have to face to maintain the highest possible standards in the management of lung cancer patients in the pandemic era. Recent Findings Evidences suggested a higher susceptibility and mortality of lung cancer patients due to COVID-19. The hard management of this patient population has been also due to the potential cross interference of anti-tumor drugs on SARS-Cov-2 infection and to the differential diagnosis between COVID-19 pneumonitis and drug-related pneumonitis. Summary COVID-19 pandemic has generated a profound reshaping of oncological activities and the development of recommendations by the oncology scientific community to prioritize anti-tumor treatments for lung cancer patients.
SARS-CoV-2 Associated Pulmonary Pathology
Encyclopedia
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel entry in the betacoronaviridae group of coronaviruses. This is the second member of this group, and the third of the family overall to emerge in the last 20 years, which has caused significant health concerns due to the clinical severity and spread of the disease it causes—coronavirus disease identified in 2019 (COVID-19). While initially emerging as a respiratory disease, and while most cases experience symptoms predominantly from this system, SARS-CoV-2 has emerged as a multisystem pathogen. From a pathomorphological point of view, the severity of changes in the respiratory system can be summed up as diffuse alveolar damage—desquamation of the alveolar epithelium with exudative and proliferative changes—pulmonary hyaline membranes, Clara cell hyperplasia, squamous cell metaplasia, and fibrosis. The second most prominent way the disease affects the lung is through endotheliitis—damage to the endothelial cells o...
Inside the lungs of COVID-19 disease
International Journal of Legal Medicine
In the setting of the coronavirus disease 2019 (COVID-19) pandemic, only few data regarding lung pathology induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is available, especially without medical intervention interfering with the natural evolution of the disease. We present here the first case of forensic autopsy of a COVID-19 fatality occurring in a young woman, in the community. Diagnosis was made at necropsy and lung histology showed diffuse alveolar damage, edema, and interstitial pneumonia with a geographically heterogeneous pattern, mostly affecting the central part of the lungs. This death related to COVID-19 pathology highlights the heterogeneity and severity of central lung lesions after natural evolution of the disease.
The pulmonary pathology of COVID-19
Virchows Archiv
The lung is the main affected organ in severe coronavirus disease 2019 (COVID-19) caused by the novel coronavirus SARS-CoV-2, and lung damage is the leading cause of death in the vast majority of patients. Mainly based on results obtained by autopsies, the seminal features of fatal COVID-19 have been described by many groups worldwide. Early changes encompass edema, epithelial damage, and capillaritis/endothelialitis, frequently combined with microthrombosis. Subsequently, patients with manifest respiratory insufficiency exhibit exudative diffuse alveolar damage (DAD) with hyaline membrane formation and pneumocyte type 2 hyperplasia, variably complicated by superinfection, which may progress to organizing/fibrotic stage DAD. These features, however, are not specific for COVID-19 and can be found in other disorders including viral infections. Clinically, the early disease stage of severe COVID-19 is characterized by high viral load, lymphopenia, massive secretion of pro-inflammatory ...
After Effects of COVID-19 and Repair of Lungs
Journal of Regenerative Medicine & Biology Research, 2021
Lung disease is the most effected organ in patients. Corona (CoV) targets the lungs and causes death of millions of patients across the globe. There has been increasing burden in lung associated disease due to the pandemic. CoV is a deadly pandemic that cause respiratory problems and affects trachea of lungs. CoV which enters the respiratory system, where enzyme is present, and destroy the respiratory organ, causing patients to face difficulty in breathing. There are two steps basically for virus to infect lungs. First pathogenesis converting enzyme to its protein, second cellular protease letting virus through respiratory system. The spike activates into membrane and releases the virus RNA. The present target for the virus is to infect the lungs, while T and B lymphocytes is always negative in ACE2. So proposed solution is stem cell treatment. The release of cytokines S1, S2 and RBD results in edena dysfunction of acute respiratory collapse and cardiac arrest.
Pathophysiology of worsening lung function in COVID-19
Revista Brasileira de Fisiologia do Exercício
Introduction: The new coronavirus pneumonia (COVID-19) has emerged as the main threats to global health since December 2019. Addressing part of the pulmonary pathophysiology involved in the disease is important to help interested health professionals better understand the different aspects of this complex pathology. Aim: This article aims to present part of the pathophysiological process involved in pulmonary complications associated with Covid-19. Methods: An integrative literature review was carried out, with articles published between 2019 and 2020, in the Google and PubMed databases, using the following search terms: coronavirus, COVID-19, pulmonary complications, pneumonia. Results: 6 articles were included, addressing the proposed theme. Conclusion: The individual's infection with COVID-19 has the potential to cause significant changes in ventilatory capacity, leading to diffuse pulmonary impairment and worsening gas exchange. Further studies are needed to clarify the path...