免疫功能低下和免疫能力强患者的长期COVID:临床,形态和病毒学肖像
Fátima Ramalhosa1, Francesca Lunardi2, Nicol Bernardinello2
1From the Pathology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal (Ramalhosa).
Archives of pathology & laboratory medicine
|October 13, 2024
概括
长期COVID肺部活检揭示了独特的组织性肺炎模式,具有血管和纤维化变化. 在一些患者中检测到SARS-CoV-2病毒,这表明在COVID后肺部疾病中病毒活动仍在继续.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 冠状病毒疾病2019 (COVID) 可以导致慢性后COVID综合征,影响肺部.
- 关于长期COVID患者病理变化的详细数据有限.
研究的目的:
- 为了评估长期COVID患者的横支气管活检中的组织形态和病毒特征.
- 为了比较长期COVID患者的免疫能力和免疫能力低下之间的发现.
主要方法:
- 对18名长期COVID患者 (9名免疫能力强,9名免疫低下) 进行跨支气管活检的回顾性观察性研究.
- 组织学变化的计算机辅助形态测量分析,包括组织性肺炎,纤维化和炎症.
- 在肺组织中调查SARS-CoV-2的存在和亚基因组转录.
主要成果:
- 与对照人群相比,长期COVID患者表现出明显的组织性肺炎模式,血管和纤维变化增加.
- 在长期COVID患者和对照人群中观察到较低的炎症 (P < .001).
- 在3名长期COVID患者的肺活检中检测到SARS-CoV-2RNA,表明潜在的病毒持久性.
结论:
- 长期的COVID与一种独特的组织性肺炎模式有关,其特点是血管和纤维化重塑.
- 包括复制形式在内的SARS-CoV-2RNA可以在免疫能力和免疫功能低下的长期COVID患者的肺活检中发现.
- 对肺组织的进一步研究对于了解长期COVID病理生物学至关重要.
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