Pulmonary Pathology of Early Phase 2019 Novel Coronavirus Pneumonia

To the Editor:

We read the publication on “Pulmonary pathology of early phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer” with great interest.¹ Tian et al.¹ concluded that “the lungs of both patients exhibited edema, proteinaceous exudate, focal reactive hyperplasia of pneumocytes with patchy inflammatory cellular infiltration, and multinucleated giant cells” and noted that “these changes likely represent an early phase of the lung pathology of COVID-19 pneumonia.” Although this pathologic finding might be a lung abnormality in COVID-19, it should not be referred to as COVID-19 pneumonia because the patients did not have pneumonia. In a previous report of a case with pneumonia and severe respiratory distress, fibromyxoid exudates and hyaline membrane formation were the main histopathologic findings.² Asymptomatic or mildly symptomatic COVID-19 is possible³ and the pathologic findings in the lungs mentioned by Tian et al.¹ should correspond to that case.