Features of the cell composition of inflammatory infiltrate in different phases of diffuse alveolar lung damage with COVID-19

Background. Acute respiratory distress syndrome (ARDS) with COVID-19 has a worse prognosis than ARDS with other diseases. Mortality from ARDS with COVID-19 is 26.0 — 61.5%, and due to other causes — 35.3—37.2%. Objective. To find of the correlation between polymorphonuclear leukocytes (PMNs), lymphocytes, and macrophages in the cellular composition of the inflammatory infiltrate at different stages and phases of diffuse alveolar damage (DAD) with COVID-19, analyzing the autopsy material. Material and methods. The lung tissue of 25 patients who died from ARDS with COVID-19 without a secondary bacterial or mycotic infection, another thanatologically significant pathology of the lungs, was studied. To study the cellular composition of the inflammatory infiltrate and the dynamics of its changes a double immunohistochemical analysis of the expression of antibodies to CD15, CD3, and CD68 was used. Results. The inflammatory infiltrate and intraalveolar exudate in the exudative phase of DAD was represented by 56.8% of PMNs (CD15-positive cells; hereinafter — the average value of the percentage of positive cells to the total number of cells of the inflammatory infiltrate), 6.9% — lymphocytes (CD3-positive cells) and 19.5% macrophages (CD68-positive cells). In the early stage of the proliferative phase: 14.1% PMNs, 38.7% lymphocytes and 13.5% macrophages. In the late stage of the proliferative phase: 11.3% PMNs, 14.5% lymphocytes and 39.3% macrophages. Conclusions. In the exudative phase of DAD a statistically significant predominance of PMN was revealed, which could determine the main volume of lung damage and the severity of ARDS with COVID-19. In the early stage of the proliferative phase of DAD, a statistically significant change in the composition of the inflammatory infiltrate was revealed to compare with the exudative phase: a significant decrease in the content of PMNs relative to the total number of cells in the inflammatory infiltrate; an increase in the number of lymphocytes, which is probably associated with the start of organization and repair processes. In the late stage of the proliferative phase of DAD, compared with its early stage, was revealed a statistically significant increase in the number of macrophages in ratio. © 2022, Media Sphera Publishing Group. All rights reserved.

Rodionov V.E. 1, 2 , Avdalyan A.M.1, 3 , Konovalov D.M.1, 4, 5 , Boriskin N.V.1 , Tyurin I.N.1 , Protsenko D.N.1, 6 , Zayratyants O.V.3, 7 , Filipenko M.L.8 , Oskorbin I.P.8 , Koryukov M.A.8
Number of issue
  • 1 Moscow Multidisciplinary Clinical Center «Komnunarka» of Moscow Healthcare department, Moscow, Russian Federation
  • 2 Peoples’ Friendship University of Russia, Moscow, Russian Federation
  • 3 A.I. Evdokimov, Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow, Russian Federation
  • 4 Dmitry Rogachev National Medical Research Center Of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
  • 5 Russian Medical Academy of Continuious Professional Education, Moscow, Russian Federation
  • 6 N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation
  • 7 Acad. A.P. Avtsyn Research Institute of Human Morphology, Moscow, Russian Federation
  • 8 Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russian Federation
acute respiratory distress syndrome; COVID-19; diffuse alveolar damage; immunohistochemistry; lymphocytes; macrophages; polymorphonuclear leukocytes
Date of creation
Date of change
Short link

Other records

Tiunova N.V., Nekrasov A.N., Vdovina L.V., Daurova F.Y., Tomaeva D.I., Popov N.V., Ayupova I.O.
Stomatologiya. Vol. 101. 2022. P. 27-30