Clinical and morphological features of lung injury long-term after SARS-CoV-2 recovery

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Abstract

Aim. To study the clinical and histological profile of lung tissue in patients with persistent pulmonary disease, respiratory symptoms and CT findings after SARS-CoV-2 infection.

Materials and methods. The study included 15 patients (7 females and 8 males) with a mean age of 57.7 years. All patients underwent laboratory tests, chest computed tomography, echocardiography, and pulmonary function tests. Pulmonary tissue and bronchoalveolar lavage samples were obtained by fibrobronchoscopy, transbronchial forceps (2 patients), and lung cryobiopsy (11 patients); open biopsy was performed in 2 patients. Cellular composition, herpesvirus DNA, SARS-CoV-2, Mycobacterium tuberculosis complex, galactomannan optical density index, and bacterial and fungal microflora growth were determined in bronchoalveolar lavage. SARS-CoV-2 was also identified in samples from the nasal mucosa, throat and feces using a polymerase chain reaction.

Results. The results showed no true pulmonary fibrosis in patients recovered from SARS-CoV-2 infection with persistent respiratory symptoms, functional impairment, and CT findings after SARS-CoV-2 infection. The observed changes comply with the current and/or resolving infection and inflammatory process.

Conclusion. Thus, no true pulmonary fibrosis was found in patients after SARS-CoV-2 infection with persistent respiratory symptoms, functional impairment, and CT findings. The observed changes comply with the current and/or resolving infection and inflammatory process.

About the authors

Gulsara E. Baimakanova

Loginov Moscow Clinical Scientific Center

Author for correspondence.
Email: g.baymakanova@mknc.ru
ORCID iD: 0000-0001-8198-9313

д-р мед. наук, зав. отд. пульмонологии ГБУЗ «МКНЦ им. А.С. Логинова»

Russian Federation, Moscow

Maria Samsonova

Loginov Moscow Clinical Scientific Center; Research Institute of Pulmonology

Email: samary@mail.ru
ORCID iD: 0000-0001-8170-1260

д-р мед. наук, ст. науч. сотр. лаб. патоморфологии ГБУЗ «МКНЦ им. А.С. Логинова», зав. лаб. патологической анатомии ФГБУ «НИИ пульмонологии»

Russian Federation, Moscow; Moscow

Andrey L. Chernyaev

Research Institute of Pulmonology; Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University

Email: cheral12@gmail.com
ORCID iD: 0000-0002-0158-7056

д-р мед. наук, проф., зав. отд. фундаментальной пульмонологии ФГБУ «НИИ пульмонологии», вед. науч. сотр. НИИМЧ им. акад. А.П. Авцына ФГБНУ «РНЦХ им. акад. Б.В. Петровского», проф. каф. патологической анатомии и клинической патологической анатомии лечебного фак-та ФГАОУ ВО «РНИМУ им. Н.И. Пирогова»

Russian Federation, Moscow; Moscow; Moscow

Andrey S. Kontorschikov

Petrovsky National Research Centre of Surgery

Email: g.baymakanova@mknc.ru
ORCID iD: 0000-0002-1032-0353

ординатор лаб. клинической морфологии НИИМЧ им. акад. А.П. Авцына ФГБНУ «РНЦХ им. акад. Б.В. Петровского»

Russian Federation, Moscow

Andrey S. Belevskiy

Pirogov Russian National Research Medical University

Email: pulmobas@yandex.ru
ORCID iD: 0000-0001-6050-724X

д-р мед. наук, проф., зав. каф. пульмонологии ФГАОУ ВО «РНИМУ им. Н.И. Пирогова», президент Российского респираторного общества, гл. внештатный специалист – пульмонолог Департамента здравоохранения г. Москвы

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Organizing focal pneumonia. Hematoxylin and eosin staining.

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3. Fig. 2. Cellular type of nonspecific interstitial pneumonia. Hematoxylin and eosin staining.

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4. Fig. 3. Fibrous type of nonspecific interstitial pneumonia. Hematoxylin and eosin staining.

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5. Fig. 4. Fibrous type of nonspecific interstitial pneumonia: thickening of the interalveolar septum due to the proliferation of myofibroblasts and fibroblasts. Immunohistochemistry: a – SMA; b – vimentin.

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6. Fig. 5. Focal intra-alveolar hemorrhage, edema. Hematoxylin and eosin staining.

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7. Fig. 6. Focal peribronchial fibrosis, represented by fibroatelectasis with slit-like structures. Hematoxylin and eosin staining.

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