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In situ detection of SARS-CoV-2 in lungs and airways of patients with COVID-19.
Mod Pathol. 2020 Jun 19 [Online ahead of print]MP

Abstract

Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has led to a global public health crisis. In elderly individuals and those with comorbidities, COVID-19 is associated with high mortality, frequently caused by acute respiratory distress syndrome. We examine in situ expression of SARS-CoV-2 in airways and lung obtained at autopsy of individuals with confirmed COVID-19 infection. Seven autopsy cases (male, N = 5; female, N = 2) with reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infection and a median age of 66 years (range, 50-77 years) were evaluated using a rabbit polyclonal antibody against SARS Nucleocapsid protein in correlation with clinical parameters. The median time from symptom onset to death was 9 days (range, 6-31 days), from hospitalization 7 days (range, 1-21 days), from positive RT-PCR 7 days (range, 0-18 days), and from intensive care unit admission defining onset of respiratory failure 3 days (range, 1-18 days). Chest imaging identified diffuse airspace disease in all patients corresponding to acute and (N = 5) or organizing (N = 2) diffuse alveolar damage (DAD) on histologic examination. Among five patients with acute-phase DAD (≤7 days from onset of respiratory failure), SARS-CoV-2 was detected in pulmonary pneumocytes and ciliated airway cells (N = 5), and in upper airway epithelium (N = 2). In two patients with organizing DAD (>14 days from onset of respiratory failure), no virus was detected in lungs or airways. No endothelial cell infection was observed. The findings suggest that SARS-CoV-2 infection of epithelial cells in lungs and airways of patients with COVID-19 who developed respiratory failure can be detected during the acute phase of lung injury and is absent in the organizing phase.

Authors+Show Affiliations

Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Healthcare Institute, Boston, MA, USA.Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. lmsholl@bwh.harvard.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32561849

Citation

Schaefer, Inga-Marie, et al. "In Situ Detection of SARS-CoV-2 in Lungs and Airways of Patients With COVID-19." Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc, 2020.
Schaefer IM, Padera RF, Solomon IH, et al. In situ detection of SARS-CoV-2 in lungs and airways of patients with COVID-19. Mod Pathol. 2020.
Schaefer, I. M., Padera, R. F., Solomon, I. H., Kanjilal, S., Hammer, M. M., Hornick, J. L., & Sholl, L. M. (2020). In situ detection of SARS-CoV-2 in lungs and airways of patients with COVID-19. Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc. https://doi.org/10.1038/s41379-020-0595-z
Schaefer IM, et al. In Situ Detection of SARS-CoV-2 in Lungs and Airways of Patients With COVID-19. Mod Pathol. 2020 Jun 19; PubMed PMID: 32561849.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - In situ detection of SARS-CoV-2 in lungs and airways of patients with COVID-19. AU - Schaefer,Inga-Marie, AU - Padera,Robert F, AU - Solomon,Isaac H, AU - Kanjilal,Sanjat, AU - Hammer,Mark M, AU - Hornick,Jason L, AU - Sholl,Lynette M, Y1 - 2020/06/19/ PY - 2020/05/22/received PY - 2020/06/05/accepted PY - 2020/06/05/revised PY - 2020/6/21/entrez PY - 2020/6/21/pubmed PY - 2020/6/21/medline JF - Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc JO - Mod. Pathol. N2 - Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has led to a global public health crisis. In elderly individuals and those with comorbidities, COVID-19 is associated with high mortality, frequently caused by acute respiratory distress syndrome. We examine in situ expression of SARS-CoV-2 in airways and lung obtained at autopsy of individuals with confirmed COVID-19 infection. Seven autopsy cases (male, N = 5; female, N = 2) with reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infection and a median age of 66 years (range, 50-77 years) were evaluated using a rabbit polyclonal antibody against SARS Nucleocapsid protein in correlation with clinical parameters. The median time from symptom onset to death was 9 days (range, 6-31 days), from hospitalization 7 days (range, 1-21 days), from positive RT-PCR 7 days (range, 0-18 days), and from intensive care unit admission defining onset of respiratory failure 3 days (range, 1-18 days). Chest imaging identified diffuse airspace disease in all patients corresponding to acute and (N = 5) or organizing (N = 2) diffuse alveolar damage (DAD) on histologic examination. Among five patients with acute-phase DAD (≤7 days from onset of respiratory failure), SARS-CoV-2 was detected in pulmonary pneumocytes and ciliated airway cells (N = 5), and in upper airway epithelium (N = 2). In two patients with organizing DAD (>14 days from onset of respiratory failure), no virus was detected in lungs or airways. No endothelial cell infection was observed. The findings suggest that SARS-CoV-2 infection of epithelial cells in lungs and airways of patients with COVID-19 who developed respiratory failure can be detected during the acute phase of lung injury and is absent in the organizing phase. SN - 1530-0285 UR - https://www.unboundmedicine.com/medline/citation/32561849/In_situ_detection_of_SARS_CoV_2_in_lungs_and_airways_of_patients_with_COVID_19_ L2 - http://dx.doi.org/10.1038/s41379-020-0595-z DB - PRIME DP - Unbound Medicine ER -
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