Most COVID-19 victims are old and die from unrelated causes. Here we present t welve complete autopsies, including two rapid autopsies of young patients where the cause of death was COVID-19 ARDS. The main virus induced pathology was in the lung parenchyma and not in the airways. Most coagulation events occurred in the intra-alveolar and not in the intra-vascular space and the few thrombi were mainly composed of aggregated thrombocytes. The dominant inflammatory response was the massive accumulation of CD163 + macrophages and the disappearance of T killer, NK and B-cells. The virus was replicating in the pneumocytes and macrophages but not in bronchial epithelium, endothelium, pericytes or stromal cells. The lung consolidations were produced by a massive regenerative response, stromal and epithelial proliferation and neovascularization. We suggest that thrombocyte aggregation inhibition, angiogenesis inhibition and general proliferation inhibition may have a roll in the treatment of advanced COVID-19 ARDS. COVID-19, autopsy, ARDS.
【저자키워드】 COVID-19, ARDS, Autopsy, 【초록키워드】 Treatment, Macrophage, pathology, lung, Angiogenesis, virus, Endothelium, Coagulation, cells, Patient, death, pericyte, Bronchial epithelium, epithelial, consolidation, regenerative, Inflammatory response, B-cells, lung parenchyma, airways, thrombocyte, proliferation, Thrombocytes, Autopsies, causes, aggregation, CD163, MOST, dominant, Complete, event, produced, occurred, composed, pneumocyte, intra-alveolar, 【제목키워드】 pulmonary, Coagulation, death, cause, intra-alveolar,