Barac Sorin, Onofrei Roxana Ramona, Lazureanu Codruta, Barna Robert, Tutelca Adrian, Rata Andreea Luciana
Department of Vascular Surgery, Research Center in Vascular and Endovascular Surgery, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Department of Rehabilitation, Physical Medicine and Rheumatology, Research Center for Assessment of Human Motion, Functionality and Disability, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Diagnostics (Basel). 2022 Feb 14;12(2):488. doi: 10.3390/diagnostics12020488.
Thromboembolic events, such as acute limb ischemia, were reported worldwide in patients with COVID-19, suggesting that SARS-CoV-2 infection acts like a redoubtable prothrombotic factor in these patients. The aim of the study was to summarize the histopathological changes found in the arterial wall, intraarterial thrombus, and adjacent skeletal muscles. Considering the lack of evidence from in vivo studies, we performed observational histological research of peripheral arterial damage in patients with acute limb ischemia and SARS-CoV-2 infection. We investigated 22 patients with acute limb ischemia and SARS and harvested histopathological samples from those who agreed to this procedure. We performed histologic tissue harvesting during the revascularization procedure from the thrombosed area of the common femoral artery. Morphologic analysis was made on the hematoxylin-eosin (HE) stain. Special stains were also used-Elastica van Gieson (EvG) and Alcian Blue-Periodic Acid-Schiff (AB-PAS) and primary antibodies-CD45 and CD61. Our patients had significant risk factors for thrombus formation, since all of them had arterial hypertension, 81% had dyslipidemia, 73% were obese, 63% suffered from diabetes mellitus, and 45% were active smokers. The histological findings using immunohistochemistry (CD45 and CD68 reactions) or special and usual stains underlined the mechanism for ischemia production in SARS-CoV-2 patients. The main histological findings in our study were endothelial destruction and inflammation that were found in all analyzed structures.
全球范围内均有报告称，新冠肺炎患者会出现血栓栓塞事件，如急性肢体缺血，这表明严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染在这些患者中就像一个强大的促血栓形成因素。本研究的目的是总结在动脉壁、动脉内血栓和相邻骨骼肌中发现的组织病理学变化。鉴于缺乏体内研究的证据，我们对急性肢体缺血和SARS-CoV-2感染患者的外周动脉损伤进行了观察性组织学研究。我们调查了22例急性肢体缺血和SARS患者，并从同意该操作的患者身上采集了组织病理学样本。我们在血管重建过程中从股总动脉的血栓形成区域进行了组织采集。对苏木精-伊红（HE）染色进行形态学分析。还使用了特殊染色——弹力纤维染色（EvG）、阿尔辛蓝-过碘酸希夫染色（AB-PAS）以及一抗——CD45和CD61。我们的患者有显著的血栓形成危险因素，因为他们所有人都患有动脉高血压，81%患有血脂异常，73%肥胖，63%患有糖尿病，45%为现吸烟者。使用免疫组织化学（CD45和CD68反应）或特殊及常规染色的组织学结果突出了SARS-CoV-2患者缺血产生的机制。我们研究的主要组织学发现是在所有分析结构中均发现了内皮破坏和炎症。
