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. 2024 Apr 30;25(9):4941. doi: 10.3390/ijms25094941

Table 1.

Pulmonary vascular findings in the main autopsy series of patients with COVID-19.

Authors Number of Patients Lung Histology
[86] N = 1
  • -

    Diffuse alveolar damage

  • -

    Abundant thrombi in medium and small-sized blood vessels
Ackermann, N Engl J Med. 2020
[7]		 N = 7
  • -

    Diffuse alveolar damage

  • -

    Perivascular T-cell infiltration

  • -

    Severe endothelial injury: intracellular virus and disrupted cell membranes

  • -

    Pulmonary vessels thrombosis

  • -

    Microangiopathy (alveolar capillary microthrombi)

  • -

    Intussusceptive angiogenesis
Borczuk, Mod Pathol. 2020
[87]		 N = 68
  • -

    Diffuse alveolar damage

  • -

    Large vessel thrombi (42%)

  • -

    Platelet and/or fibrin microthrombi (84%)

  • -

    Small vessels: basal membrane reduplication and significant endothelial swelling with cytoplasmic vacuolization
Bösmüller, Virchows Arch, 2020
[88]		 N = 4
  • -

    Endotheliitis: multiple microthrombi

  • -

    Diffuse alveolar damage
Bradley, Lancet. 2020
[89]		 N = 14
  • -

    Diffuse alveolar damage (acute or organizing phase)

  • -

    Focal pulmonary microthrombi (N = 5)
De Michele, Am J Clin Pathol, 2020.
[90]		 N = 40
  • -

    Acute lung injury (73%)

  • -

    Intravascular fibrin or platelet-rich aggregates (90%)

  • -

    Hemangiomatosis-like change (50%)
Elsoukkary, Patholiology, 2020
[91]		 N = 32
  • -

    Large vessel thrombi (34%), small vessel thrombi (72%) or both (28%)

  • -

    Exsudative and proliferative diffuse alveolar damage

  • -

    Organizing pneumonia
Fox, Lancet Respir Med 2020
[62]		 N = 10
  • -

    Thrombosis and microangiopathy in the small vessels and capillaries

  • -

    Diffuse alveolar damage: hyaline membranes
Hanley, Lancet Microbe. 2020
[92]		 N = 9
  • -

    Thrombosis (89%)

  • -

    Diffuse alveolar damage
Kianzad, Respirology 2021 [93] N = 8
  • -

    Diffuse alveolar damage

+/− microvascular damage and thrombosis
Lax, Ann Intern Med. 2020
[94]		 N = 10
  • -

    Diffuse alveolar damage

  • -

    Thrombosis of small and mid-sized pulmonary arteries (+infarction in eight patients)
Luo, 2020
[95]		 N = 1
  • -

    Extensive pulmonary interstitial fibrosis

  • -

    Alveolitis

  • -

    Necrotizing bronchiolitis

  • -

    Pulmonary hemorrhagic infarct

  • -

    Hyperplasia, wall thickening and lumen stenosis/occlusion in small vessels

  • -

    Interstitial infiltration of inflammatory cells
Menter, Histopathology. 2020
[71]		 N = 21
  • -

    Exudative diffuse alveolar damage

  • -

    Massive capillary congestion with microthrombi

  • -

    Pulmonary embolism (N = 4)

  • -

    Alveolar Hemorrhage (N = 3)

  • -

    Vasculitis (N = 1)
Miggiolaro, Viruses 2023 [96] N = 24
  • -

    Activated endothelial cells and high levels of ICAM-1, Angiopoietin-2, IL-1β)

  • -

    Microthrombosis

  • -

    Tissue expression of VEGF and VEGFR-1
Rapkiewicz, EClinicalMedicine. 2020
[97]		 N = 7
  • -

    Pulmonary arteries thrombi (N = 4)

  • -

    Megakaryocytes and platelet-rich thrombi in the lungs
Schaller, JAMA. 2020
[98]		 N = 10
  • -

    Acute and organizing diffuse alveolar damage
Tian, J Thorac Oncol, 2020 [99] N = 2
  • -

    Edema

  • -

    Proteinaceous exudate

  • -

    Inflammation: fibrinoid material and multinucleated giant cells
Varga, Lancet. 2020
[77]		 N = 3
  • -

    Viral elements within endothelial cells
Wichmann, Ann Intern Med. 2020 [25] N = 12
  • -

    Massive pulmonary embolism (N = 4)

  • -

    Diffuse alveolar damage: hyaline membranes and activated pneumocytes

  • -

    Microvascular thromboemboli

  • -

    Capillary congestion

  • -

    Protein-enriched interstitial edema

  • -

    Inflammatory infiltrate (lymphocytes)

  • -

    Squamous metaplasia in the end stages
Xu, Lancet Respir Med. 2020 [8] N = 1
  • -

    Bilateral diffuse alveolar damage

  • -

    Hyaline membrane formation

  • -

    Interstitial lymphocytar infiltrates

  • -

    Enlarged pneumocytes
Yao, Cell Res 2020 [100] N = 1
  • -

    Diffuse alveolar damage

  • -

    Formation of hyaline membranes in the alveolar space

  • -

    Thickening of the alveolar septa

  • -

    Interstitial inflammation

  • -

    Thrombus in the microvessels

  • -

    No pulmonary edema
Youd, J Clin Pathol. 2020
[101]		 N = 9
  • -

    Diffuse alveolar damage
Zhang, Ann Intern Med, 2020 [102] N = 1
  • -

    Diffuse alveolar damage

  • -

    Type II pneumocyte hyperplasia

  • -

    Chronic inflammatory infiltrates

  • -

    Intra-alveolar fibrinous exudates + organizing fibrin