Pezzuto Federica, Lunardi Francesca, Vedovelli Luca, Olteanu Gheorghe E, Fortarezza Francesco, De Pellegrin Alessandro, Melan Luca, Faccioli Eleonora, De Franceschi Elisa, Giraudo Chiara, Del Vecchio Claudia, Marinello Serena, Pasello Giulia, Gregori Dario, Navalesi Paolo, Rea Federico, Schiavon Marco, Calabrese Fiorella
Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova Medical School, Padova, Italy.
University Hospital of Padova, Padova, Italy.
Histopathology. 2023 Aug;83(2):229-241. doi: 10.1111/his.14930. Epub 2023 Apr 27.
While there is partial evidence of lung lesions in patients suffering from long COVID there are substantial concerns about lung remodelling sequelae after COVID-19 pneumonia. The aim of the present retrospective comparative study was to ascertain morphological features in lung samples from patients undergoing tumour resection several months after SARS-CoV-2 infection.
The severity of several lesions with a major focus on the vascular bed was analysed in 2 tumour-distant lung fragments of 41 cases: 21 SARS-CoV-2 (+) lung tumour (LT) patients and 20 SARS-CoV-2 (-) LT patients. A systematic evaluation of several lesions was carried out by combining their scores into a grade of I-III. Tissue SARS-CoV-2 genomic/subgenomic transcripts were also investigated. Morphological findings were compared with clinical, laboratory and radiological data. SARS-CoV-2 (+) LT patients with previous pneumonia showed more severe parenchymal and vascular lesions than those found in SARS-CoV-2 (+) LT patients without pneumonia and SARS-CoV-2 (-) LT patients, mainly when combined scores were used. SARS-CoV-2 viral transcripts were not detected in any sample. SARS-CoV-2 (+) LT patients with pneumonia showed a significantly higher radiological global injury score. No other associations were found between morphological lesions and clinical data.
To our knowledge, this is the first study that, after a granular evaluation of tissue parameters, detected several changes in lungs from patients undergoing tumour resection after SARS-CoV-2 infection. These lesions, in particular vascular remodelling, could have an important impact overall on the future management of these frail patients.
虽然有部分证据表明长期新冠患者存在肺部病变，但人们对新冠病毒肺炎后的肺重塑后遗症仍有诸多担忧。本回顾性比较研究的目的是确定感染SARS-CoV-2数月后接受肿瘤切除患者的肺样本中的形态学特征。
分析了41例患者的2个远离肿瘤的肺组织切片中几种主要累及血管床的病变严重程度，其中21例为SARS-CoV-2（+）肺肿瘤（LT）患者，20例为SARS-CoV-2（-）LT患者。通过将几种病变的评分合并为I-III级进行系统评估。还研究了组织中的SARS-CoV-2基因组/亚基因组转录本。将形态学结果与临床、实验室和放射学数据进行比较。既往有肺炎的SARS-CoV-2（+）LT患者比无肺炎的SARS-CoV-2（+）LT患者和SARS-CoV-2（-）LT患者表现出更严重的实质和血管病变，主要是在使用综合评分时。在任何样本中均未检测到SARS-CoV-2病毒转录本。有肺炎的SARS-CoV-2（+）LT患者的放射学整体损伤评分显著更高。未发现形态学病变与临床数据之间的其他关联。
据我们所知，这是第一项在对组织参数进行细致评估后，发现SARS-CoV-2感染后接受肿瘤切除患者肺部有几种变化的研究。这些病变，尤其是血管重塑，可能对这些体弱患者的未来管理产生重要的总体影响。
