Case report: histopathology and molecular pathology analysis on enteric tissue of a COVID-19 patient

Diagnostic Pathology

Lvyin Hu¹  Jilin Cheng²  Tangkai Qi³  Yun Ling³  Hongzhou Lu³  Shu Song⁴  Yanling Feng⁴  Dong Zeng⁴  Yuhan Shi⁴  Jingjing Xu⁴  Yuexiang Yang⁴  Wenjuan Guo⁴  Feng Li⁵  Qingguo Wu⁵ 

[1] Department of Clinical Laboratory, Shanghai Public Health Clinical center, Fudan University, Shanghai, China;Department of Digestive Diseases, Shanghai Public Health Clinical center, Fudan University, Shanghai, China;Department of Infectious Disease, Shanghai Public Health Clinical center, Fudan University, Shanghai, China;Department of Pathology, Shanghai Public Health Clinical center, Fudan University, Shanghai, China;Department of Respiratory Medicine, Shanghai Public Health Clinical center, Fudan University, Shanghai, China;

关键词: COVID-19;    SARS-CoV-2;    In situ hybridization;    Case report;   

DOI  :  10.1186/s13000-021-01082-7

来源: Springer

【 摘 要 】

AimsPatients with COVID-19 can also have enteric symptoms. Here we analyzed the histopathology of intestinal detachment tissue from a patient with COVID-19.MethodsThe enteric tissue was examined by hematoxylin & eosin stain, PAS (Periodic acid–Schiff) staining, Gram staining, Ziehl–Neelsen stain and Grocott’s Methenamine Silver (GMS) Stain. The distribution of CD3, CD4, CK20 and CD68, cytomegalovirus (CMV) and Herpes Simplex Virus (HSV) antigen were determined by immunohistochemistry. In situ hybridization (ISH) of SARS-CoV-2 and Epstein-Barr virus-encoded small RNA (EBER) were also performed.ResultsWe observed mucosal epithelium shedding, intestinal mucosal erosion, focal inflammatory necrosis with hemorrhage, massive neutrophil infiltration, macrophage proliferation accompanied by minor lymphocyte infiltration. Fungal spores and gram positive cocci but not mycobacteria tuberculosis were identified. Immunohistochemistry staining showed abundant CD68+ macrophages but few lymphocytes infiltration. HSV, CMV and EBV were negative. ISH of SARS-CoV-2 RNA showed positive signal which mostly overlapped with CD68 positivity.ConclusionsThe in situ detection of SARS-CoV-2 RNA in intestinal macrophages implicates a possible route for gastrointestinal infection. Further study is needed to further characterize the susceptibility of enteric cells to SARS-CoV-2 infection.

【 授权许可】

CC BY