Gheban-Roșca Ioana-Andreea, Gheban Bogdan-Alexandru, Pop Bogdan, Mironescu Daniela-Cristina, Siserman Vasile Costel, Jianu Elena Mihaela, Drugan Tudor, Bolboacă Sorana D
Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania.
Clinical Hospital for Infectious Diseases, 400348 Cluj-Napoca, Romania.
Diagnostics (Basel). 2024 Apr 27;14(9):914. doi: 10.3390/diagnostics14090914.
The primary targets of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the lungs are type I pneumocytes, macrophages, and endothelial cells. We aimed to identify lung cells targeted by SARS-CoV-2 using viral nucleocapsid protein staining and morphometric features on patients with fatal COVID-19. We conducted a retrospective analysis of fifty-one autopsy cases of individuals who tested positive for SARS-CoV-2. Demographic and clinical information were collected from forensic reports, and lung tissue was examined for microscopic lesions and the presence of specific cell types. Half of the evaluated cohort were older than 71 years, and the majority were male (74.5%). In total, 24 patients presented diffuse alveolar damage (DAD), and 50.9% had comorbidities (56.9% obesity, 33.3% hypertension, 15.7% diabetes mellitus). Immunohistochemical analysis showed a similar pattern of infected macrophages, infected type I pneumocytes, and endothelial cells, regardless of the presence of DAD ( > 0.5). The immunohistochemical reactivity score (IRS) was predominantly moderate but without significant differences between patients with and without DAD ( = 0.633 IRS for type I pneumocytes, = 0.773 IRS for macrophage, and = 0.737 for IRS endothelium). The nucleus/cytoplasm ratio shows lower values in patients with DAD (median: 0.29 vs. 0.35), but the difference only reaches a tendency for statistical significance ( = 0.083). Our study confirms the presence of infected macrophages, type I pneumocytes, and endothelial cells with a similar pattern in patients with and without diffuse alveolar damage.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在肺部的主要靶细胞是I型肺细胞、巨噬细胞和内皮细胞。我们旨在通过对因新冠肺炎死亡患者进行病毒核衣壳蛋白染色和形态计量学分析，来确定SARS-CoV-2的肺靶向细胞。我们对51例SARS-CoV-2检测呈阳性的个体尸检病例进行了回顾性分析。从法医报告中收集人口统计学和临床信息，并检查肺组织的微观病变和特定细胞类型的存在情况。评估队列中一半患者年龄超过71岁，大多数为男性（74.5%）。总共有24例患者出现弥漫性肺泡损伤（DAD），50.9%的患者有合并症（56.9%肥胖、33.3%高血压、15.7%糖尿病）。免疫组织化学分析显示，无论是否存在DAD，感染的巨噬细胞、感染的I型肺细胞和内皮细胞的模式相似（>0.5）。免疫组织化学反应评分（IRS）主要为中度，但有DAD和无DAD的患者之间无显著差异（I型肺细胞IRS = 0.633，巨噬细胞IRS = 0.773，内皮细胞IRS = 0.737）。DAD患者的核/质比显示较低值（中位数：0.29对0.35），但差异仅达到统计学意义的趋势（ = 0.083）。我们的研究证实，有弥漫性肺泡损伤和无弥漫性肺泡损伤的患者中，感染的巨噬细胞、I型肺细胞和内皮细胞的存在模式相似。
