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Case Reports
. 2024 May 22:14:e2024491.
doi: 10.4322/acr.2024.491. eCollection 2024.

Thrombosis of the vasa vasorum of the large and medium size pulmonary artery and vein leads to pulmonary thromboembolism in COVID-19

Hubert Daisley  1 , Oneka Acco  2 , Martina Daisley  3 , Dennecia George  4 , Lilly Paul  2 , Errol James  5 , Arlene Rampersad  1 , Farhaana Narinesingh  1 , Ornella Humphrey  1 , Johann Daisley  4 , Melissa Nathan  6
Affiliations
Case Reports

Thrombosis of the vasa vasorum of the large and medium size pulmonary artery and vein leads to pulmonary thromboembolism in COVID-19

Hubert Daisley et al. Autops Case Rep. .

Abstract

The vasa vasorum of the large pulmonary vessels is involved in the pathology of COVID-19. This specialized microvasculature plays a major role in the biology and pathology of the pulmonary vessel walls. We have evidence that thrombosis of the vasa vasorum of the large and medium-sized pulmonary vessels during severe COVID-19 causes ischemia and subsequent death of the pulmonary vasculature endothelium. Subsequent release of thrombi from the vasa interna into the pulmonary circulation and pulmonary embolism generated at the ischemic pulmonary vascular endothelium site, are the central pathophysiological mechanisms in COVID-19 responsible for pulmonary thromboembolism. The thrombosis of the vasa vasorum of the large and medium-sized pulmonary vessels is an internal event leading to pulmonary thromboembolism in COVID-19.

Keywords: COVID-19; Pulmonary Embolism; Thromboembolism; Vasa Vasorum.

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Conflict of interest statement

Conflict of interest: None.

Figures

Figure 1
Figure 1. Photomicrograph of the lung. A – thrombosis of the vasa interna (black arrow) of a pulmonary vein in COVID-19 (H&E 10x20); B – thrombosis of the vasa interna (black arrow) of a pulmonary artery with thrombosis of the pulmonary artery, in COVID-19(H&E 10x20); C – thrombosis of the vasa externa (black arrow) and fibrin thrombus within the lumen in COVID-19&E 10x20); D – thrombosis of a medium size pulmonary artery with thrombosis of its vasa interna (black arrow) and new thrombus formation within the lumen (blue arrow) in COVID-19 (H&E 10x20).
Figure 2
Figure 2. Photomicrograph of the lung. A – multiple vasa interna thrombosis (black arrows) in the wall of a pulmonary artery, and fibrin thrombus in its lumen of the pulmonary artery (green arrow) in COVID-19 (H&E 10x20); B – thrombosis of arterioles (black arrows) and capillaries (blue arrow) of the lungs in COVID-19 (H&E 10x20); C – thrombi in the vasa vasorum interna (black arrows) and fibrin thrombus in the lumen of the pulmonary artery, COVID-19 (H&E 10x20); D – thrombosis of venule (black arrow) in COVID-19 (H&E 10x20).
Figure 3
Figure 3. Photomicrograph of the lung. A – thrombosis of vasa interna of pulmonary vein in COVID-19 (black arrow)(H&E 10x20); B – thrombosis of the vasa interna (black arrow) of a pulmonary artery in COVID-19 and prostate cancer. There is also pulmonary hemorrhage (H&E 10x40); C – thrombosis of vasa interna (black arrow) of pulmonary artery in COVID-19 with impending embolism (H&E 10x40); D – thrombosis of vasa interna (black arrow) of the pulmonary artery in COVID-19 with impending embolism (H&E 10x40).
See this image and copyright information in PMC

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