【摘 要】
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Severe COVID-19 disease caused by SARS-CoV-2 is frequently accompanied by dysfunction of the lungs and extrapulmonary organs.However,the organotropism of SARS-CoV-2 and the port of virus entry for systemic dissemination remain largely unknown.We profiled
【机 构】
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Institute of Pathology,Southwest Hospital,Third Military Medical University(Army Medical University)
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Severe COVID-19 disease caused by SARS-CoV-2 is frequently accompanied by dysfunction of the lungs and extrapulmonary organs.However,the organotropism of SARS-CoV-2 and the port of virus entry for systemic dissemination remain largely unknown.We profiled 26 COVID-19 autopsy cases from four cohorts in Wuhan,China,and determined the systemic distribution of SARS-CoV-2.SARS-CoV-2 was detected in the lungs and multiple extrapulmonary organs of critically ill COVID-19 patients up to 67 days after symptom onset.Based on organotropism and pathological features of the patients,COVID-19 was divided into viral intrapulmonary and systemic subtypes.In patients with systemic viral distribution,SARS-CoV-2 was detected in monocytes,macrophages,and vascular endothelia at blood-air barrier,blood-testis barrier,and filtration barrier.Critically ill patients with long disease duration showed decreased pulmonary cell proliferation,reduced viral RNA,and marked fibrosis in the lungs.Permanent SARS-CoV-2 presence and tissue injuries in the lungs and extrapulmonary organs suggest direct viral invasion as a mechanism of pathogenicity in critically ill patients.SARS-CoV-2 may hijack monocytes,macrophages,and vascular endothelia at physiological barriers as the ports of entry for systemic dissemination.Our study thus delineates systemic pathological features of SARS-CoV-2 infection,which sheds light on the development of novel COVID-19 treatment.
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