Background Pulmonary hyperinflammation is a key event with SARS-CoV-2 infection. Acute respiratory distress syndrome (ARDS) that often accompanies COVID-19 appears to have worse outcomes than ARDS from other causes. To date, numerous lung histological studies in cases of COVID-19 have shown extensive inflammation and injury, but the extent to which these are a COVID-19 specific, or are an ARDS and/or mechanical ventilation (MV) related phenomenon is not clear. Furthermore, while lung hyperinflammation with ARDS (COVID-19 or from other causes) has been well studied, there is scarce documentation of vascular inflammation in COVID-19 lungs. Methods Lung sections from 8 COVID-19 affected and 11 non-COVID-19 subjects, of which 8 were acute respiratory disease syndrome (ARDS) affected (non-COVID-19 ARDS) and 3 were from subjects with non-respiratory diseases (non-COVID-19 non-ARDS) were H&E stained to ascertain histopathological features. Inflammation along the vessel wall was also monitored by expression of NLRP3 and caspase 1. Results In lungs from COVID-19 affected subjects, vascular changes in the form of microthrombi in small vessels, arterial thrombosis, and organization were extensive as compared to lungs from non-COVID-19 (i.e., non-COVID-19 ARDS and non-COVID-19 non-ARDS) affected subjects. The expression of NLRP3 pathway components was higher in lungs from COVID-19 ARDS subjects as compared to non-COVID-19 non-ARDS cases. No differences were observed between COVID-19 ARDS and non-COVID-19 ARDS lungs. Conclusion Vascular changes as well as NLRP3 inflammasome pathway activation were not different between COVID-19 and non-COVID-19 ARDS suggesting that these responses are not a COVID-19 specific phenomenon and are possibly more related to respiratory distress and associated strategies (such as MV) for treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-01944-8.
【저자키워드】 COVID-19, NLRP3 inflammasome, Microthrombosis, Lung inflammation, Vascular endothelium, Mechanical ventilation, 【초록키워드】 Treatment, Inflammation, ARDS, thrombosis, mechanical ventilation, SARS-COV-2 infection, lung, outcome, pulmonary, response, hyperinflammation, Lungs, pathway, disease, expression, caspase, NLRP3, Injury, distress, acute respiratory disease, microthrombi, Non-COVID-19, Activation, Vascular, supplementary material, subject, causes, syndrome, vessels, component, vascular inflammation, vessel wall, histopathological features, Result, shown, affected, appear, changes in, subjects, not different, accompany, histological, H&E, Vascular change, 【제목키워드】 coronavirus disease, pulmonary, vascular inflammation,