Long COVID in Immunocompromised and Immunocompetent Patients: A Clinical, Morphologic, and Virologic Portrait.

Context.--Coronavirus disease 2019 (COVID) primarily affects the lung and can lead to chronic/post-COVID syndrome. Some insights about late pulmonary changes occurring in patients recovering from COVID have been published, but the evidence of detailed pathologic changes coming from follow-up care pa...

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Publicado en:Archives of Pathology & Laboratory Medicine Vol. 149; no. 6; pp. 535 - 542
Autores principales: Ramalhosa, Fátima, Lunardi, Francesca, Bernardinello, Nicol, Gori, Silvia, Pezzuto, Federica, Tauro, Veronica, Del Vecchio, Claudia, Giraudo, Chiara, Balestro, Elisabetta, Calabrese, Fiorella
Formato: diagnostic images pictorial research tables/charts Journal Article
Publicado: College of American Pathologists Jun2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2025
      vid: 149
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      pub: College of American Pathologists
      place: Northfield, Illinois
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        atl: Long COVID in Immunocompromised and Immunocompetent Patients: A Clinical, Morphologic, and Virologic Portrait.
      aug:
        au:
          Ramalhosa, Fátima
          Lunardi, Francesca
          Bernardinello, Nicol
          Gori, Silvia
          Pezzuto, Federica
          Tauro, Veronica
          Del Vecchio, Claudia
          Giraudo, Chiara
          Balestro, Elisabetta
          Calabrese, Fiorella
        affil: Pathology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
      sug:
        subj:
          Post-Acute COVID-19 Syndrome Immunology
          Post-Acute COVID-19 Syndrome Microbiology
          Post-Acute COVID-19 Syndrome Pathology
          Lung Anatomy and Histology
          Immunocompromised Host
          Immunocompetence
          Lung Transplantation
          Transplant Recipients
          Disease Attributes
          Biopsy
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Retrospective Design
          Nonexperimental Studies
          Ambulatory Care Facilities
          Outpatients
          Comparative Studies
          Descriptive Statistics
          Pilot Studies
          Molecular Structure
          Correlational Studies
          Tomography, X-Ray Computed
          Lung Radiography
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Context.--Coronavirus disease 2019 (COVID) primarily affects the lung and can lead to chronic/post-COVID syndrome. Some insights about late pulmonary changes occurring in patients recovering from COVID have been published, but the evidence of detailed pathologic changes coming from follow-up care patients with long COVID is limited. Objective.--To evaluate tissue morphologic and viral features in transbronchial biopsies of long COVID patients (immunocompetent and immunocompromised). Design.--This retrospective observational study included 18 patients (9 immunocompetent and 9 immunocompromised) who were consecutively referred to our outpatient clinic for post-COVID pneumonia, undergoing transbronchial biopsy. Several histologic changes were analyzed by computer-assisted morphometric analysis. As organizing pneumonia (OP) was consistently detected, fibrosis and inflammation were also evaluated in transbronchial biopsies from 28 control patients with histologic confirmation of OP. Tissue SARS-CoV-2 and the subgenomic transcripts were investigated. Morphologic findings were correlated with clinical and radiologic data. Results.--Long COVID patients showed lower inflammation than controls (P < .001) despite a similar fibrotic extension. When considering separately the 2 long COVID groups, the same inflammatory infiltrate extension was found, whereas a higher fibrotic remodeling characterized the immunocompetent subgroup (P = .05). Molecular investigation showed that SARS-CoV-2 was present in tissue samples obtained from 3 long COVID patients. Conclusions.--Long COVID patients showed a peculiar OP pattern, with more vascular and fibrotic changes. SARS-CoV-2 RNA, even in replicative status, can be detected in lung biopsies of both immunocompetent and immunocompromised patients. This pilot study is a forerunner of more in-depth lung tissue investigations to gain a better understanding of long COVID pathobiology.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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