Pathological findings of COVID-19 associated with acute respiratory distress syndrome
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Most patients with severe COVID-19 have substantially elevated serum levels of proinflammatory cytokines and chemokines, which contribute to pneumonia, cytokine storm, ARDS, sepsis and coagulopathy.
“The majority of patients with severe COVID-19 demonstrate substantially elevated serum levels of proinflammatory cytokines and chemokines, including IL-6, IL-1β, IL-2, IL-8, IL-17, G-CSF, GM-CSF, CXCL10, CCL2, CCL3 and TNF49,54,68.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [49]
In COVID-19, ARDS appears as diffuse alveolar damage on autopsy and is linked to lung immune cell infiltration, cytokine storm and tissue damage.
“During COVID-19, ARDS manifests as a diffuse alveolar damage pattern seen on autopsies of COVID-19 patients, and is linked to a combination of lung immune cell infiltration, cytokine storm, and tissue damage from secreted proteases, reactive oxygen species (ROS), and viral killing 49,50.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [49]
Pro-thrombotic coagulopathy, high D-dimer, venous thromboembolism, arterial thromboses and fibrin-based occlusion of small vessels are associated with severe COVID-19.
“Pro-thrombotic coagulopathy, high levels of D-dimer, venous thromboembolism, arterial thromboses, and fibrin-based occlusion of small blood vessels have all been associated with cases of severe COVID-197,44,49,93-99.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [49]
Severe COVID-19 patients commonly develop Acute Respiratory Distress Syndrome, characterized by inflammatory injury to the alveoli-capillary membrane, leading to lung over-permeability and increased pulmonary edema fluid into the airspaces, resulting in lack of respiratory capacity.
“Severe COVID-19 patients commonly develop the Acute Respiratory Distress Syndrome [38], which is characterized by inflammatory injury to the alveoli–capillary membrane, leading to lung over-permeability and increased pulmonary edema fluid into the airspaces, resulting in the lack of respiratory capacity [39].”
From Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology (2021) · cites this paper as [38]
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- Authors
- Xu, Z., Shi, L., Wang, Y., Zhang, J., Huang, L., Zhang, C., Liu, S., Zhao, P., Liu, H., Zhu, L., Tai, Y., Bai, C., Gao, T., Song, J., Xia, P., Dong, J., Zhao, J., & Wang, F.-S.
- Affiliations
- Chinese PLA General Hospital (CN)
- Corresponding author
- Zhao, Jingmin
- Wang, Fu-Sheng
- ORCID
- Venue
- The Lancet Respiratory Medicine
- Publisher
- Elsevier BV
- Published
- 2020-04
- Volume
- 8
- Issue
- 4
- Pages
- 420-422
- ISSN
- 2213-2600 (ISSN-L)
- PMC
- PMC7164771
- OpenAlex
- W3007940623
- Cited by
- 8,545
- References
- 5
- Citations by year
- 2026: 80 · 2025: 179 · 2024: 354 · 2023: 731 · 2022: 1251 · 2021: 2434 · 2020: 3501 · 2019: 4 · 2018: 1 · 2015: 1 · 2013: 1 · 2012: 1
- FWCI
- 260.04
- Type
- journal article
- Language
- en
- Update notices
- erratum (2020-04-01)
- Open access
- bronze
- doi.org
- Locations
- The Lancet Respiratory Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- COVID-19 pandemic, acute respiratory distress syndrome, pathological features, SARS-CoV-2, alveolar damage, respiratory failure, autopsy, lung pathology
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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