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Pathogenesis of COVID-19; Acute Auto-inflammatory Disease (Endotheliopathica & Leukocytoclastica COVIDicus).

Authors :
Bahadori, Moslem
Dabiri, Shahriar
Javadi, Abdolreza
Meymandi, Simin Shamsi
Movahedinia, Sajjadeh
Meymandi, Manzumeh Shamsi
Khorasani, Parisa
Farrokhnia, Mehrdad
Yousefi, Meysam
Sarrafzadeh, Farhad
Abosaidi, Hamid
Shojaeepour, Saeedeh
Mortazaizadeh, Abbas
Rezaei, Mitra
Dabiri, Bahram
Mohabati, Nader
Ranjbar, Hanie
Rashidinejad, Sara
Feizy, Abdolamir
Source :
Archives of Iranian Medicine (AIM). May2021, Vol. 24 Issue 5, p419-426. 8p.
Publication Year :
2021

Abstract

Background: The pathogenesis of the COVID19 pandemic, that has killed one million nine hundred people and infected more the 90 million until end of 2020, has been studied by many researchers. Here, we try to explain its biological behavior based on our recent autopsy information and review of literature. Methods: In this study, patients with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) result were considered eligible for enrollment. Histopathological examinations were done on 13 people who were hospitalized in Afzalipour hospital, Kerman, Iran. Clinical and laboratory data were reviewed. Tissue examination was done by light microscopy, immunohistochemistry and electron microscopy. Results: The most frequent co-morbidity in the patients was cardiovascular disease. The common initial symptoms of COVID-19 infection were dyspnea and cough. In all cases, the number of white blood cells was higher than the normal range. Common histopathological findings were variable degrees of vasculitis as degenerative to necrotic changes of endothelium and trafficking of inflammatory cells in the vessel wall with fibrinoid necrosis. Tissue damage included interstitial acute inflammatory cells reaction with degenerative to necrotic changes of the parenchymal cells. CD34 and Factor VIII immunohistochemistry staining showed endothelial cell degeneration to necrosis at the vessel wall and infiltration by inflammatory cells. Electron microscopic features confirmed the degenerative damages in the endothelial cells. Conclusion: Our histopathological studies suggest that the main focus of the viral damage is the endothelial cells (endotheliopathica) in involved organs. Also, our findings suggest that degeneration of leukocytes occurs at the site of inflammation and release of cytokines (leukocytoclastica) resulting in a cytokine storm. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
10292977
Volume :
24
Issue :
5
Database :
Academic Search Index
Journal :
Archives of Iranian Medicine (AIM)
Publication Type :
Academic Journal
Accession number :
151858264
Full Text :
https://doi.org/10.34172/aim.2021.60