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. 2022 Jul 21;40(12):1845–1854. doi: 10.1038/s41587-022-01382-3

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© The Author(s) 2022

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 6 — a–e, Lungs of untreated hamsters at day 2/3 p.i. developed marked inflammation. a, Whole slide scan revealing consolidation of approximately 60% of the left lung. b, Untreated hamsters had moderate necro-suppurative and hyperplastic bronchiolitis with intraluminal accumulation of neutrophils and cellular debris (asterisk) as well as neutrophils transmigrating through the bronchial epithelium into the lumen (arrowhead). The lung parenchyma presented with a patchy distribution of acute necrosis (c, asterisk) with microvascular thrombosis (arrowheads) or with areas of dense infiltration by macrophages and neutrophils (d). e, Pulmonary blood vessels had mild to moderate endothelialitis. f–i, Lungs of hamsters treated with ensovibep on the day of infection developed moderately less consolidation of their lungs (f). g, Bronchiolitis was milder with less inflammatory cell infiltrate compared to the untreated group. Neutrophils were mostly absent. h, Alveolar walls were only moderately expanded by neutrophils and macrophages with less alveolar edema compared to untreated hamsters. i, Endothelialitis was virtually absent with marginating neutrophils as only immune cells interacting with the vascular lining. j–m, Hamsters treated with the antibody cocktail at the day of infection developed lesions that were similar to those as described for the ensovibep-treated group. n–w, In contrast, lungs of hamsters treated at 1 day p.i. had lesions similar to the untreated hamsters at that time, regardless of their treatments. o,t, Both treatment groups developed moderate bronchiolitis similarly to the untreated group. p,u, Interstitial (asterisks) and alveolar (arrowheads) infiltration with neutrophils and macrophages with variable necrosis of alveolar epithelial cells. Additional lesions in both treatment groups included moderate to marked alveolar edema (q, asterisk), here shown for the ensovibep group, and moderate interstitial edema (v, asterisk), here shown for the antibody group. r,w, Both treatment groups developed moderate endothelialitis with monomorphonuclear infiltrates underneath detached endothelial cells, similarly to the untreated group. Scale bars: a, f, j, n, s, 1 mm; b, g, k, o, t, 50 µm; c, d, h, l, p, q, u, v, e, i, m, r, w, 20 µm.