Chapter 3 Pathological Changes

Based on the current limited autopsy and puncture histopathological observations are summarized below.

(1) The Lungs

The lungs showed consolidation to varying degrees.

Serum, fibrinous exudate, and transparent membrane formation were seen in the alveolar cavity; exudation cells were mainly mononuclear and macrophages, and multinucleated giant cells were easily seen. Type II alveolar epithelial cells proliferated significantly, and some cells were shed. Type II alveolar epithelial cells and macrophages

Visible inclusions. Alveolar septal vascular congestion and edema, monocyte and lymphocytic infiltration and intravascular clear thrombosis can be seen. Focal hemorrhage and necrosis of lung tissue may occur with hemorrhagic infarction. Partial alveolar exudate mechanization and pulmonary interstitial fibrosis.

Partial epithelium of the bronchial private membrane in the lungs shed, and Guo fluid and private fluid plugs were seen in the cavity to make. A small number of alveoli are over-inflated, the alveolar septum is broken, or the cysts are formed. Coronavirus particles can be seen in the cytoplasm of bronchial shadow epithelium and type II alveolar epithelial cells under the electron microscope. Immunohistochemical staining showed some alveolar epithelium and macrophages were new Coronavirus antigen positive, RT-PCR detection of new coronavirus nucleic acid positive.

(2) Spleen, Hilar Lymph Nodes and Bone Marrow.

The spleen was significantly reduced. The number of lymphocytes was significantly reduced, focal hemorrhage and necrosis, macrophage proliferation and phagocytosis in the spleen were observed; Less, visible necrosis. Immunohistochemical staining showed that CD4+T and CD8+T cells were reduced in the spleen and lymph nodes. Bone marrow three-line cells decreased.

(3) Heart and Blood Vessels.

Degeneration and necrosis of myocardial cells, few monocytes and lymphocytes in interstitial Infiltration of lymphocytes and / or neutrophils. Partial vascular endothelial shedding, endometritis Disease and thrombosis.

(4) Liver and Gallbladder.

Increased volume, dark red. Hepatocyte degeneration, focal necrosis with neutrophils Infiltration; hepatic sinus congestion, lymphocytes and monocytes infiltration in the manifold area, microthrombosis. The gallbladder is highly filled.

(5) The Kidney.

There is a proteinous exudate in the glomerular cavity, Visible transparent cast. Interstitial hyperemia, visible microthrombus and focal fibrosis.

(6) Other Organs.

Congestion and edema of brain tissue, and degeneration of some neurons. Adrenal glands show focal necrosis. The esophageal, gastric, and intestinal epithelial membranes are degenerated, necrotic, and detached to varying degrees.