Pulmonary Artery Vasa Vasorum Damage in Severe COVID-19–Induced Pulmonary Fibrosis

Annals of thoracic surgery short reports Pub Date : 2024-09-01 DOI:10.1016/j.atssr.2023.12.019

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Abstract

Background

COVID-19 patients exhibit higher incidence of thrombosis in arteries and veins, including those in lungs. Vasa vasorum, which support large blood vessels, have shown involvement in these pathologic processes.

Methods

To further explore the extent of microvascular damage caused by COVID-19 infection, we examined resected main, right, or left pulmonary artery specimens from patients undergoing bilateral lung transplantation for COVID-19– or non–COVID-19–induced pulmonary fibrosis compared with organ donors by histologic and immunohistologic analyses.

Results

Vasa vasorum density was found to be higher in specimens procured from patients with COVID-19 and associated with pulmonary artery hypertension compared with lung transplant donors. In addition, we found immunothrombosis within vasa vasorum in specimens from COVID-19 patients with more immune infiltration, including CD15⁺, CD44⁺, and CD68⁺ cells.

Conclusions

These findings reveal that COVID-19 affects the vasa vasorum of pulmonary arteries and suggest that infection may lead to large-vessel dysfunction and organ failure.

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严重 COVID-19 诱导的肺纤维化中的肺动脉血管损伤

背景COVID-19患者动脉和静脉血栓形成的发生率较高，包括肺部。为了进一步探究COVID-19感染对微血管造成的损伤程度，我们通过组织学和免疫组织学分析，对因COVID-19或非COVID-19诱发的肺纤维化而接受双侧肺移植的患者切除的主、右或左肺动脉标本进行了检查，并与器官捐献者进行了比较。结果我们发现，与肺移植供体相比，COVID-19 患者标本中的脉管密度更高，且与肺动脉高压有关。此外，我们还发现 COVID-19 患者标本中的血管内存在免疫栓塞，并伴有更多的免疫浸润，包括 CD15+、CD44+ 和 CD68+ 细胞。

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