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Background: Patients with severe coronavirus disease 2019 (COVID-19) have respiratory failure with hypoxemia and acute bilateral pulmonary infiltrates, consistent with ARDS. Respiratory failure in COVID-19 might represent a novel pathologic entity.

Research Question: How does the lung histopathology described in COVID-19 compare with the lung histopathology described in SARS and H1N1 influenza?

Study Design and Methods: We conducted a systematic review to characterize the lung histopathologic features of COVID-19 and compare them against findings of other recent viral pandemics, H1N1 influenza and SARS. We systematically searched MEDLINE and PubMed for studies published up to June 24, 2020, using search terms for COVID-19, H1N1 influenza, and SARS with keywords for pathology, biopsy, and autopsy. Using PRISMA-Individual Participant Data guidelines, our systematic review analysis included 26 articles representing 171 COVID-19 patients; 20 articles representing 287 H1N1 patients; and eight articles representing 64 SARS patients.

Results: In COVID-19, acute-phase diffuse alveolar damage (DAD) was reported in 88% of patients, which was similar to the proportion of cases with DAD in both H1N1 (90%) and SARS (98%). Pulmonary microthrombi were reported in 57% of COVID-19 and 58% of SARS patients, as compared with 24% of H1N1 influenza patients.

Interpretation: DAD, the histologic correlate of ARDS, is the predominant histopathologic pattern identified in lung pathology from patients with COVID-19, H1N1 influenza, and SARS. Microthrombi were reported more frequently in both patients with COVID-19 and SARS as compared with H1N1 influenza. Future work is needed to validate this histopathologic finding and, if confirmed, elucidate the mechanistic underpinnings and characterize any associations with clinically important outcomes.

Titel:	Lung Histopathology in Coronavirus Disease 2019 as Compared With Severe Acute Respiratory Sydrome and H1N1 Influenza: A Systematic Review.
Autor/in / Beteiligte Person:	Hariri, LP ; North, CM ; Shih, AR ; Israel, RA ; Maley, JH ; Villalba, JA ; Vinarsky, V ; Rubin, J ; Okin, DA ; Sclafani, A ; Alladina, JW ; Griffith, JW ; Gillette, MA ; Raz, Y ; Richards, CJ ; Wong, AK ; Ly, A ; Hung, YP ; Chivukula, RR ; Petri, CR ; Calhoun, TF ; Brenner, LN ; Hibbert, KA ; Medoff, BD ; Hardin, CC ; Stone, JR ; Mino-Kenudson, M
Zeitschrift:	Chest, Jg. 159 (2021), Heft 1, S. 73-84
Veröffentlichung:	2016- : New York : Elsevier ; <i>Original Publication</i>: Chicago : American College of Chest Physicians, 2021
Medientyp:	academicJournal
ISSN:	1931-3543 (electronic)
DOI:	10.1016/j.chest.2020.09.259
Schlagwort:	Humans COVID-19 pathology Influenza A Virus, H1N1 Subtype Influenza, Human pathology Lung pathology Respiratory Distress Syndrome pathology
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Systematic Review Language: English [Chest] 2021 Jan; Vol. 159 (1), pp. 73-84. <i>Date of Electronic Publication: </i>2020 Oct 07. MeSH Terms: Influenza A Virus, H1N1 Subtype* ; COVID-19 / pathology ; Influenza, Human / pathology ; Lung / pathology ; Respiratory Distress Syndrome / pathology ; Humans References: Am J Clin Pathol. 2010 Mar;133(3):380-7. (PMID: 20154276) ; N Engl J Med. 2020 Jul 9;383(2):182-183. (PMID: 32437597) ; Am J Pathol. 2010 Jul;177(1):166-75. (PMID: 20508031) ; Intensive Care Med. 2020 Jun;46(6):1124-1126. (PMID: 32328726) ; Lancet. 2003 May 24;361(9371):1773-8. (PMID: 12781536) ; Arch Pathol Lab Med. 2002 Sep;126(9):1064-70. (PMID: 12204055) ; Am J Clin Pathol. 2020 May 5;153(6):725-733. (PMID: 32275742) ; Am J Respir Crit Care Med. 2020 May 15;201(10):1299-1300. 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Lung Histopathology in Coronavirus Disease 2019 as Compared With Severe Acute Respiratory Sydrome and H1N1 Influenza: A Systematic Review.