Abstract
Current understanding of the complex pathogenesis of COVID-19 interstitial pneumonia pathogenesis in the light of biopsies carried out in early/moderate phase and histology data obtained at postmortem analysis is discussed. In autopsies the most observed pattern is diffuse alveolar damage with alveolar-epithelial type-II cell hyperplasia, hyaline membranes, and frequent thromboembolic disease. However, these observations cannot explain some clinical, radiological and physiopathological features observed in SARS-CoV-2 interstitial pneumonia, including the occurrence of vascular enlargement on CT and preserved lung compliance in subjects even presenting with or developing respiratory failure. Histological investigation on early-phase pneumonia on perioperative samples and lung biopsies revealed peculiar morphological and morpho-phenotypical changes including hyper-expression of phosphorylated STAT3 and immune checkpoint molecules (PD-L1 and IDO) in alveolar-epithelial and endothelial cells. These features might explain in part these discrepancies.
【초록키워드】 SARS-CoV-2, Pathogenesis, Respiratory failure, Pneumonia, lung, Autopsy, immune, PD-L1, Morphological, endothelial cells, Diffuse alveolar damage, interstitial pneumonia, histology, change, Analysis, biopsy, hyaline membranes, observation, Lung compliance, STAT3, Vascular, subject, complex, thromboembolic disease, pathogenesis of COVID-19, discrepancies, feature, Cell, radiological, current, Occurrence, carried, phosphorylated, presenting, explain, IDO, preserved, 【제목키워드】 COVID-19, epithelial, Endothelial cell, pathogenic,