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Case Reports
. 2020 May 2;395(10234):1417-1418.
doi: 10.1016/S0140-6736(20)30937-5. Epub 2020 Apr 21.

Endothelial cell infection and endotheliitis in COVID-19

Zsuzsanna Varga  1 , Andreas J Flammer  2 , Peter Steiger  3 , Martina Haberecker  1 , Rea Andermatt  3 , Annelies S Zinkernagel  4 , Mandeep R Mehra  5 , Reto A Schuepbach  3 , Frank Ruschitzka  6 , Holger Moch  1
Affiliations
Case Reports

Endothelial cell infection and endotheliitis in COVID-19

Zsuzsanna Varga et al. Lancet. .
No abstract available

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Figures

Figure
Figure
Pathology of endothelial cell dysfunction in COVID-19 (A, B) Electron microscopy of kidney tissue shows viral inclusion bodies in a peritubular space and viral particles in endothelial cells of the glomerular capillary loops. Aggregates of viral particles (arrow) appear with dense circular surface and lucid centre. The asterisk in panel B marks peritubular space consistent with capillary containing viral particles. The inset in panel B shows the glomerular basement membrane with endothelial cell and a viral particle (arrow; about 150 nm in diameter). (C) Small bowel resection specimen of patient 3, stained with haematoxylin and eosin. Arrows point to dominant mononuclear cell infiltrates within the intima along the lumen of many vessels. The inset of panel C shows an immunohistochemical staining of caspase 3 in small bowel specimens from serial section of tissue described in panel D. Staining patterns were consistent with apoptosis of endothelial cells and mononuclear cells observed in the haematoxylin-eosin-stained sections, indicating that apoptosis is induced in a substantial proportion of these cells. (D) Post-mortem lung specimen stained with haematoxylin and eosin showed thickened lung septa, including a large arterial vessel with mononuclear and neutrophilic infiltration (arrow in upper inset). The lower inset shows an immunohistochemical staining of caspase 3 on the same lung specimen; these staining patterns were consistent with apoptosis of endothelial cells and mononuclear cells observed in the haematoxylin-eosin-stained sections. COVID-19=coronavirus disease 2019.
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References

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