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Successful recovery of severe COVID-19 with cytokine storm treating with extracorporeal blood purification.

ABSTRACT: COVID-19 associated cytokine storm could induce ARDS rapidly and the patients would require the support of mechanic ventilation. However, the prognosis was not that optimistic. The outcome might be changed if the intervention of EBP was performed timely. We present a case of severe SARS-CoV-2 infection who recovered from cytokine storm.

SUBMITTER: Wang Q

PROVIDER: S-EPMC7255259 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Successful recovery of severe COVID-19 with cytokine storm treating with extracorporeal blood purification.

Wang Qiang Q Hu Zhao Z

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 20200526

COVID-19 associated cytokine storm could rapidly induce ARDS, and the patients would require mechanical ventilation. However, the prognosis was not that optimistic. The outcome might be changed if the timely intervention of EBP was performed. We present a case of severe SARS-CoV-2 infection who recovered from a cytokine storm. ...[more]

PMID: 32470601

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Project description:BackgroundThe novel coronavirus pneumonia COVID-19 caused by SARS-CoV-2 infection could lead to a series of clinical symptoms and severe illnesses, including acute respiratory distress syndrome (ARDS) and fatal organ failure. We report the fundamental pathological investigation in the lungs and other organs of fatal cases for the mechanistic understanding of severe COVID-19 and the development of specific therapy in these cases.MethodsThe autopsy and pathological investigations of specimens were performed on bodies of two deceased cases with COVID-19. Gross anatomy and histological investigation by Hematoxylin and eosin (HE) stained were reviewed on each patient. Alcian blue/periodic acid-Schiff (AB-PAS) staining and Masson staining were performed for the examinations of mucus, fibrin and collagen fiber in lung tissues. Immunohistochemical staining was performed on the slides of lung tissues from two patients. Real-time PCR was performed to detect the infection of SARS-CoV-2. Flow cytometry analyses were performed to detect the direct binding of S protein and the expression of ACE2 on the cell surface of macrophages.FindingsThe main pathological features in lungs included extensive impairment of type I alveolar epithelial cells and atypical hyperplasia of type II alveolar cells, with formation of hyaline membrane, focal hemorrhage, exudation and pulmonary edema, and pulmonary consolidation. The mucous plug with fibrinous exudate in the alveoli and the dysfunction of alveolar macrophages were characteristic abnormalities. The type II alveolar epithelial cells and macrophages in alveoli and pulmonary hilum lymphoid tissue were infected by SARS-CoV-2. S protein of SARS-CoV-2 directly bound to the macrophage via the S-protein-ACE2 interaction.InterpretationInfection of alveolar macrophage by SARS-CoV-2 might be drivers of the "cytokine storm", which might result in damages in pulmonary tissues, heart and lung, and lead to the failure of multiple organs .FundingShanghai Guangci Translational Medical Research Development Foundation, Shanghai, China.

Dataset Information

Successful recovery of severe COVID-19 with cytokine storm treating with extracorporeal blood purification.

Publications

Successful recovery of severe COVID-19 with cytokine storm treating with extracorporeal blood purification.

Similar Datasets

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