Histopathological features in fatal COVID-19 acute respiratory distress syndrome

Background

COVID-19 acute respiratory distress syndrome (ARDS) shares the common histological hallmarks with other forms of ARDS. However, the chronology of the histological lesions has not been well established.

Objective

To describe the chronological histopathological alterations in the lungs of patients with COVID-19 related ARDS.

Design

A prospective cohort study was carried out.

Setting

Intensive Care Unit of a tertiary hospital.

Patients

The first 22 consecutive COVID-19 deaths.

Measurements

Lung biopsies and histopathological analyses were performed in deceased patients with COVID-19 related ARDS. Clinical data and patient course were evaluated.

Results

The median patient age was 66 [63–74] years; 73% were males. The median duration of mechanical ventilation was 17 [8–24] days. COVID-19 induced pulmonary injury was characterized by an exudative phase in the first week of the disease, followed by a proliferative/organizing phase in the second and third weeks, and finally an end-stage fibrosis phase after the third week. Viral RNA and proteins were detected in pneumocytes and macrophages in a very early stage of the disease, and were no longer detected after the second week.

Limitation

Limited sample size.

Conclusions

The chronological evolution of COVID-19 lung histopathological lesions seems to be similar to that seen in other forms of ARDS. In particular, lung lesions consistent with potentially corticosteroid-sensitive lesions are seen.

Histopathological features in fatal COVID-19 acute respiratory distress syndrome

Background

COVID-19 acute respiratory distress syndrome (ARDS) shares the common histological hallmarks with other forms of ARDS. However, the chronology of the histological lesions has not been well established.

Objective

To describe the chronological histopathological alterations in the lungs of patients with COVID-19 related ARDS.

Design

A prospective cohort study was carried out.

Setting

Intensive Care Unit of a tertiary hospital.

Patients

The first 22 consecutive COVID-19 deaths.

Measurements

Lung biopsies and histopathological analyses were performed in deceased patients with COVID-19 related ARDS. Clinical data and patient course were evaluated.

Results

The median patient age was 66 [63–74] years; 73% were males. The median duration of mechanical ventilation was 17 [8–24] days. COVID-19 induced pulmonary injury was characterized by an exudative phase in the first week of the disease, followed by a proliferative/organizing phase in the second and third weeks, and finally an end-stage fibrosis phase after the third week. Viral RNA and proteins were detected in pneumocytes and macrophages in a very early stage of the disease, and were no longer detected after the second week.

Limitation

Limited sample size.

Conclusions

The chronological evolution of COVID-19 lung histopathological lesions seems to be similar to that seen in other forms of ARDS. In particular, lung lesions consistent with potentially corticosteroid-sensitive lesions are seen.

Method of Calculating the Fluid Permeability of Machined Skin-Covered Porous Sheets from Experimental Flow Data

Porous polymer sheets created by the “solid state microcellular foaming process” possess an impermeable solid skin on the boundary. In order to experimentally determine the internal structure's fluid permeability, the skin is removed by machining a pattern of holes or channels so that fluid flow can be established when applying a pressure difference across the faces. In this work, a fluid flow model for this particular geometry assuming a Newtonian fluid and isotropic internal porous structure is established. This yields formulae used to compute the structure's Darcy permeability from experimental flow data. Experimental verification of the model is provided for a sample of Polyetherimide (PEI) nanoporous polymer sheet whose skin was drilled in various hole patterns, thus establishing the mathematical foundation for future work in investigating this class of porous materials.

Unknown: A woman with an erythematous nodule on the scalp

A 77-year-old healthy woman presented with an isolated exophytic lesion of the scalp for 4 years, which had grown progressively. On exam, there was a 4 cm, firm erythematous and lobulated tumor with telangiectasias on the scalp. The rest of her cutaneous exam was normal. No lymphadenopathy was appreciated. A solitary cylindroma was diagnosed by biopsy.

[Glaucoma as primary optic neuropathy]

The appearance of the new concept of glaucomatous optic neuropathy directed to idea that high intraocular pressure and vascular insufficiency in the optic nerve head are only risk factors in the appearance of glaucoma. Glaucomatous optic neuropathy is the consequence of progressive loss of the retinal ganglion cells whose axons comprise the optic nerve. A great number of neurotrophic agents are under investigation with the view of preventing the dead of retinal ganglion cells. Induction of cell rescue mechanisms may be an alternate and efficient strategy for neuroprotection. The paper presents both actual data about the pathophysiological mechanisms of glaucoma (neurotrophin deprivation, excitotoxicity caused by glutamate, "ischemic cascade", apoptosis of retinal ganglion cells) and neuroprotective and neuroregenerative therapy and antiapoptotic agents.

[Ophthalmologic involvement of intracranial tumors--report of a case]

Bilateral papillary edema is considered to be the expression of a tumoral process that reduces the intracranial space resulting in elevation of the intracranial cerebrospinal fluid pressure. The authors present the case of a 21-year-old man consulting for mild visual loss of the left eye. The ophthalmologic examination showed bilateral papilledema and visual field defects in the left eye (enlargement of the blind spot), with no clinic or imagistic signs of increased intracranial pressure. Intracranial pathologic processes that bear like a tumor, reducing the intracranial space are not always associated with papilledema, but papilledema is always associated with intracranial tumor. Increased intracranial pressure is frequently associated with intracranial tumoral processes, but in this case was not showed increasing of intracranial pressure.

[Postcontusion glaucoma]

Secondary posttraumatic glaucoma. Blunt ocular trauma may cause transient or permanent high IOP, occurring immediately or in time after the injury. This study presents some clinical and therapeutical considerations about 16 cases which developed secondary glaucoma. The elevation of IOP was associated with hyphema, iridodialysis, zonular tears (with lens luxation or subluxations), alterations of the iridocorneal angle.

The antifungal activity of 2,2'-diamino-4,4'-dithiazole derivatives is due to the possible inhibition of lanosterol-14-alpha-demethylase

Aryl/alkyl sulfonylamido-, arylsulfenylamido-, arylcarboxamido- and ureido/thioureido/guanidino derivatives of 2,2'-diamino-4,4'-dithiazole were prepared by reaction of the title compound with sulfonyl/sulfenyl halides, sulfonic acid anhydrides, acyl chlorides, tosyl isocyanate, aryl/allyl isocyanates or isothiocyanates. Mono- as well as bis-derivatized compounds have been obtained. Several of the newly synthesized compounds act as effective antifungal agents against Aspergillus and Candida spp., some of them showed activities comparable to ketoconazole (with minimum inhibitory concentrations in the range of 0.2-1.8 microg/mL) but possessed lower activity as compared to itraconazole. Greatest activity was detected against A. niger, and least activity against C. albicans. The mechanism of action of these compounds probably involves inhibition of ergosterol biosynthesis, and interaction with lanosterol-14-alpha-demethylase (CYP51A1), since reduced amounts of ergosterol were found by means of HPLC in cultures of the sensitive strain A. niger treated with some of these inhibitors. Thus, the compounds reported here and the azole antifungal derivatives might possess a similar mechanism of action at molecular level.

Complex compounds of Pd(II), Pt(II), Ni(II), Hg(II) and Cu(I) with 1-benzylidene-2-phenazinoylhydrazine

Synthesis and physical-chemistry characterization of five new genuine complex compounds of 1-Benzylidine-2-phenazinoylhydrazine with Pd(II), Pt(II), Ni(II), Hg(II) and Cu(I) are presented. The chemical structure for these complexes is suggested by the elemental chemical analysis, molecular mass measurements, electric conductivities as well as by IR and UV-VIS spectra. The metal:ligand molar ratio is found 1:1, the obtained complexes belonging to the square planar geometry D4h.

[Varicella associated with Lyell's syndrome after administration of sulfametin]

A case of chickenpox associated with Lyell syndrome, which appeared after the administration of sulfamethine, is reported. Quantitative determination of the immunoglobulins showed marked immunologic changes in the course of the syndrome. Antistaphylococcal treatment, without corticotherapy led to clinical recovery.