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. 2021 Oct 4;12:735922. doi: 10.3389/fimmu.2021.735922

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Copyright © 2021 Valdebenito, Bessis, Annane, Lorin de la Grandmaison, Cramer–Bordé, Prideaux, Eugenin and Bomsel

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Quantification of cell structure and lung damage in lethal cases of COVID-19. (A–F) Correspond to the quantification of different cell types in different compartments of the lung, including blood vessels (black bars), parenchyma (white bars), blood lesions (dark lead-colored bars), and cells surrounding hemorrhagic lesions (lead-colored bars). (A) In control conditions (LC for lung carcinoma), minimal numbers of macrophages were detected (mostly resident macrophages). In contrast, in the COVID-19 enhanced coagulation phenotype (EC), a strong infiltration of monocyte/macrophages into the lung parenchyma and around hemorrhagic lesions. Moreover, in the COVID-19 immune infiltration phenotype that lacks hemorrhagic lesions, most macrophages were in the lung parenchyma. (*p ≤ 0.005 compared to lung carcinoma conditions and ^#p ≤ 0.0001 compared to enhanced coagulation condition, n = 4 different individuals with five sections each). (B) Quantification of CD3 cells in different lung compartments as described above. A small and localized CD3 response was found (*p ≤ 0.001 compared to lung carcinoma conditions, n = 13 different individuals with five sections each). (C) Quantification of CD8 cells as compared to uninfected samples obtained from individuals with suspected lung carcinoma. Overall, COVID-19 induced a poor CD8 response in the lung in these lethal cases (*p ≤ 0.005 as compared to lung carcinoma conditions, n = 13 different individuals with five sections each). (D) Quantification of smooth muscle cells indicates a strong negative effect of COVID-19 in these cells. Overall, SMA or SMC were eliminated by the infection independent of the area analyzed and the damage type induced by COVID-19 infection (*p ≤ 0.001 compared to lung carcinoma conditions, n = 13 different individuals with five sections each). (E) Quantification of vimentin-positive cells in COVID-19 lethal cases. Overall, there was a significant and strong increase in Vimentin positive cells, especially in the lung parenchyma (*p ≤ 0.0001 compared to lung carcinoma conditions, n = 13 different individuals with five sections each). (F) Quantification of epithelial cells in COVID-19 cases, overall, there is a significant decrease in EpCam staining and numbers of positive cells; however, a critical point is the de-attachment of the remaining epithelial cells from the alveolar wall (*p ≤ 0.0005 compared to lung carcinoma conditions, n = 13 different individuals with 5 section each). (G) representative image of the distribution of the viral protein M and the viral mRNA (sense). It is possible to observe the accumulation of these viral components in the circulation and not in the parenchyma (H, I, for viral protein M and viral mRNA, respectively. (*p ≤ 1x10^-7 compared to lung carcinoma conditions, n = 13 different individuals with 5 sections each).