Table 2.
Light microscopic, immunohistochemical and ultrastructural findings of MERS‐CoV infection
| Organ | LM | IHC | VP localisation by EM |
|---|---|---|---|
| Lung | DAD, interstitial and alveolar acute and chronic inflammation, haemorrhagic NP, focal intimal arteritis | CD68+ macrophages and CD3+/CD4+/CD8+ lymphocytes in interstitium, alveolar walls and spaces; focal, predominantly CD4+ lymphocytic intimal arteritis | Pneumocytes and pulmonary macrophagesa |
| Kidney | AKI, mild glomerular ischemic changes | No significant inflammatory cell infiltrate | PTECa |
| Skeletal muscle | Atrophic changes, regenerative changes and myositis | CD68+ macrophages and CD3+/CD4+/CD8+ lymphocytes in perimysium and endomysium (atrophic myofibres > non‐atrophic myofibres) | Infiltrating macrophagesa |
| Liver | Mild lymphocytic chronic portal inflammation, mild lobular reactive changes and sinusoidal lymphocytosis, perivenular congestion, haemorrhage and loss of hepatocytes | CD3+/CD4+/CD8+ lymphocytes in portal tracts and sinusoidal spaces | Not identified |
| Brian and heart | Unremarkable | No significant inflammatory cell infiltrate | Not identified |
LM, light microscopy; IHC, immunohistochemistry; VP, viral particles; EM, electron microscopy; DAD, diffuse alveolar damage; NP, necrotizing pneumonitis; AKI, acute kidney injury; PTEC, proximal tubular epithelial cells; MERS‐CoV, Middle East respiratory syndrome – coronavirus.
a
Cytoplasmic.
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