Lungs’ Microscopic Patterns of Vessels in Patients Deceased with or by SARS-CoV-2 Infection
Keywords:COVID19; endothelium; forensics; lung parenchyma; pathology;SARS-CoV-2; vessels
Background: even if specific mechanisms are not completely understood, several studies highlighted Severe
Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) ability to alter vascular homeostasis. In the
literature, multiple reports of microscopic pulmonary findings of vascular structures in patients deceased by
or with SARS-Cov-2 infection are available. Nevertheless, the scientific literature lacks a systematic analysis
of these findings. Methods: the authors realized a systematic review of the literature in order to identify
common microscopic patterns representative of pulmonary vascular damage: useful data for pathologists in
clinical and forensic settings. The research yielded 23 articles (79 total cases). Quali/quantitative analysis
was carried out. Conclusion: the review allowed to identify vascular thrombosis (especially in lesser caliber
vessels) as common microscopic pattern. The recurrence of this pattern was confirmed by scientific literature
data which demonstrate SARS-CoV-2 ability to interfere with coagulation cascade. Other meaningful
microscopic findings were also discussed, even if their low frequency in study population did not allow to
define them as common.
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