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What Open-Lung Biopsy Teaches Us about ARDS in COVID-19 Patients: Mechanisms, Pathology, and Therapeutic Implications
Joint Authors
Abourida, Yassamine
Rebahi, Houssam
Chichou, Hajar
Fenane, Hicham
Msougar, Yassine
Fakhri, Anas
Hazmiri, Fatima Ezzahra
Ismail, Ayman
Rais, Hanane
Soraa, Nabila
Samkaoui, Mohammed Abdenasser
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-11, 11 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-12-10
Country of Publication
Egypt
No. of Pages
11
Main Subjects
Abstract EN
Difficulties have risen while managing Acute Respiratory Distress Syndrome (ARDS) caused by COVID-19, although it meets the Berlin definition.
Severe hypoxemia with near-normal compliance was noted along with coagulopathy.
Understanding the precise pathophysiology of this atypical ARDS will assist researchers and physicians in improving their therapeutic approach.
Previous work is limited to postmortem studies, while our report addresses patients under protective lung mechanical ventilation.
An open-lung minithoracotomy was performed in 3 patients who developed ARDS related to COVID-19 and were admitted to the intensive care unit to carry out a pathological and microbiological analysis on lung tissue biopsy.
Diffused alveolar damage with hyaline membranes was found, as well as plurifocal fibrin microthrombi and vascular congestion in all patients’ specimens.
Microbiological cultures were negative, whereas qualitative Reversed Transcriptase Polymerase Chain Reaction (RT-PCR) detected SARS-CoV-2 in the pulmonary parenchyma and pleural fluid in two patients.
COVID-19 causes progressive ARDS with onset of severe hypoxemia, underlying a dual mechanism: shunt effect through diffused alveolar damage and dead space effect through thrombotic injuries in microvascular beds.
It seems reasonable to manage this ventilation-perfusion ratio mismatch using a high dose of anticoagulant combined with glucocorticoids.
American Psychological Association (APA)
Abourida, Yassamine& Rebahi, Houssam& Chichou, Hajar& Fenane, Hicham& Msougar, Yassine& Fakhri, Anas…[et al.]. 2020. What Open-Lung Biopsy Teaches Us about ARDS in COVID-19 Patients: Mechanisms, Pathology, and Therapeutic Implications. BioMed Research International،Vol. 2020, no. 2020, pp.1-11.
https://search.emarefa.net/detail/BIM-1132802
Modern Language Association (MLA)
Abourida, Yassamine…[et al.]. What Open-Lung Biopsy Teaches Us about ARDS in COVID-19 Patients: Mechanisms, Pathology, and Therapeutic Implications. BioMed Research International No. 2020 (2020), pp.1-11.
https://search.emarefa.net/detail/BIM-1132802
American Medical Association (AMA)
Abourida, Yassamine& Rebahi, Houssam& Chichou, Hajar& Fenane, Hicham& Msougar, Yassine& Fakhri, Anas…[et al.]. What Open-Lung Biopsy Teaches Us about ARDS in COVID-19 Patients: Mechanisms, Pathology, and Therapeutic Implications. BioMed Research International. 2020. Vol. 2020, no. 2020, pp.1-11.
https://search.emarefa.net/detail/BIM-1132802
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1132802