Viral Load and Patterns of SARS-CoV-2 Dissemination to the Lungs, Mediastinal Lymph Nodes, and Spleen of Patients with COVID-19 Associated Lymphopenia

Viruses

Tatiana Lipina¹  Igor Babichenko²  Akmaljon Odilov²  Alexey Volkov²  Tatiana Gasanova³  Maxim Ershler⁴  Adhamjon Abdullaev⁵  Andrey Sudarikov⁵  Yuri Lebedin⁶ 

[1] Department of Cell Biology and Histology, Faculty of Biology, Lomonosov Moscow State University, Leninskie Gori, 1, 12, 119234 Moscow, Russia;Department of Pathological Anatomy, Peoples’ Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya St, 117198 Moscow, Russia;Department of Virology, Lomonosov Moscow State University, Leninskie Gori, 1, 40, 119234 Moscow, Russia;National Research Center for Hematology, Hematopoiesis Physiology Laboratory, Novy Zykovski Lane 4a, 125167 Moscow, Russia;National Research Center for Hematology, Laboratory of Molecular Hematology, Novy Zykovski Lane 4a, 125167 Moscow, Russia;XEMA Company Limited, 9th Parkovaya St., 48, 105043 Moscow, Russia;

关键词: COVID-19;    SARS-CoV-2;    multiplex real-time polymerase chain reaction;    viral load;    lymphopenia;   

DOI  :  10.3390/v13071410

来源: DOAJ

【 摘 要 】

Lymphopenia is a frequent hematological manifestation, associated with a severe course of COVID-19, with an insufficiently understood pathogenesis. We present molecular genetic immunohistochemical, and electron microscopic data on SARS-CoV-2 dissemination and viral load (VL) in lungs, mediastinum lymph nodes, and the spleen of 36 patients who died from COVID-19. Lymphopenia <1 × 10⁹/L was observed in 23 of 36 (63.8%) patients. In 12 of 36 cases (33%) SARS-CoV-2 was found in lung tissues only with a median VL of 239 copies (range 18–1952) SARS-CoV-2 cDNA per 100 copies of ABL1. Histomorphological changes corresponding to bronchopneumonia and the proliferative phase of DAD were observed in these cases. SARS-CoV-2 dissemination into the lungs, lymph nodes, and spleen was detected in 23 of 36 patients (58.4%) and was associated with the exudative phase of DAD in most of these cases. The median VL in the lungs was 12,116 copies (range 810–250281), lymph nodes—832 copies (range 96–11586), and spleen—71.5 copies (range 0–2899). SARS-CoV-2 in all cases belonged to the 19A strain. A immunohistochemical study revealed SARS-CoV-2 proteins in pneumocytes, alveolar macrophages, and bronchiolar epithelial cells in lung tissue, sinus histiocytes of lymph nodes, as well as cells of the Billroth pulp cords and spleen capsule. SARS-CoV-2 particles were detected by transmission electron microscopy in the cytoplasm of the endothelial cell, macrophages, and lymphocytes. The infection of lymphocytes with SARS-CoV-2 that we discovered for the first time may indicate a possible link between lymphopenia and SARS-CoV-2-mediated cytotoxic effect.

【 授权许可】

Unknown