Structural and physiological changes of the human body upon SARS-CoV-2 infection / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Since December 2019, the novel coronavirus (severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) has spread to many countries around the world, developing into a global pandemic with increasing numbers of deaths reported worldwide. To data, although some vaccines have been developed, there are no ideal drugs to treat novel coronavirus pneumonia (coronavirus disease 2019 (COVID-19)). By examining the structure of the coronavirus and briefly describing its possible pathogenesis based on recent autopsy reports conducted by various teams worldwide, this review analyzes the possible structural and functional changes of the human body upon infection with SARS-CoV-2. We observed that the most prominent pathological changes in COVID-19 patients are diffuse alveolar damage (DAD) of the lungs and microthrombus formation, resulting in an imbalance of the ventilation/perfusion ratio and respiratory failure. Although direct evidence of viral infection can also be found in other organs and tissues, the viral load is relatively small. The conclusion that the injuries of the extra-pulmonary organs are directly caused by the virus needs further investigation.

Host metabolism dysregulation and cell tropism identification in human airway and alveolar organoids upon SARS-CoV-2 infection

The coronavirus disease 2019 (COVID-19) pandemic is caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is spread primary via respiratory droplets and infects the lungs. Currently widely used cell lines and animals are unable to accurately mimic human physiological conditions because of the abnormal status of cell lines (transformed or cancer cells) and species differences between animals and humans. Organoids are stem cell-derived self-organized three-dimensional culture in vitro and model the physiological conditions of natural organs. Here we showed that SARS-CoV-2 infected and extensively replicated in human embryonic stem cells (hESCs)-derived lung organoids, including airway and alveolar organoids which covered the complete infection and spread route for SARS-CoV-2 within lungs. The infected cells were ciliated, club, and alveolar type 2 (AT2) cells, which were sequentially located from the proximal to the distal airway and terminal alveoli, respectively. Additionally, RNA-seq revealed early cell response to virus infection including an unexpected downregulation of the metabolic processes, especially lipid metabolism, in addition to the well-known upregulation of immune response. Further, Remdesivir and a human neutralizing antibody potently inhibited SARS-CoV-2 replication in lung organoids. Therefore, human lung organoids can serve as a pathophysiological model to investigate the underlying mechanism of SARS-CoV-2 infection and to discover and test therapeutic drugs for COVID-19.

Presencia de trombosis y hallazgos anatomopatológicos post mortem en 109 pacientes con COVID-19 / Presence of thrombosis and post-mortem pathological findings in 109 patients with COVID-19

INTRODUCCIÓN: En 6 meses se notificaron más de 400 mil fallecidos por COVID-19. Han surgido múltiples investigaciones para comprender su etiopatogenia, siendo la autopsia médica uno de los mejores procedimientos para obtener información. Presentamos una revisión respecto a hallazgos post mortem publicados hasta mayo, 2020. RESULTADOS: Se recolectaron 12 estudios, de un total de 109 pacientes cuyo deceso fue por complicación respiratoria, predominó el sexo masculino, edad avanzada y con múltiples comorbilidades. El estudio PCR se realizó principalmente para diagnóstico. Se demostró ARN viral en riñón, hígado, corazón, cerebro y otros órganos. Los autores relataron presencia de micro y/o macro trombosis, en 50 de 109 casos, sobre todo a nivel pulmonar y renal, de tipo microscópica y relacionados a signos de shock. Desde la perspectiva anatomopatológica, se centra en alteraciones pulmonares y renales: daño alveolar difuso, injuria tubular aguda, microtrombos y otros signos de alteración microcirculatoria. Los estudios inmunohistoquímicos, de inmunofluoresencia y microscopía electrónica sugieren tropismo del virus por células epiteliales y estromales a nivel pulmonar y renal. En otros órganos se encuentran elementos morfológicos inespecíficos, atribuibles a patologías de base o shock. CONCLUSIÓN: El patrón histopatológico de daño alveolar difuso es frecuente, principalmente en fase exudativa o temprana. En el tejido renal destaca la injuria tubular aguda y daño microcirculatorio. El número y la descripción de muestras en otros órganos es reducida, siendo necesaria mayor casuística. La trombosis, es un trastorno prevalente en pulmones y riñones de pacientes con signos de shock. El tipo de trombo con más frecuencia descrito, es el microtrombo. Si bien se puede explicar como gatillante del fenómeno trombótico la interacción entre agente y huésped, otros factores deben ser estudiados para dilucidar la patogenia.

Computed tomography findings in a Brazilian cohort of 48 patients with pneumonia due to coronavirus disease

Abstract INTRODUCTION: This study was conducted to retrospectively review chest computed tomography (CT) findings in a Brazilian cohort of patients with pneumonia caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: Chest CT scans of 78 patients with confirmed coronavirus disease (COVID-19), obtained in March and April 2020, were reviewed. Of 78 cases, the CT scans of 48 (61.5%) showed lung opacities. CT opacity features, their distribution, and the extent of infiltration were evaluated. RESULTS: The most common CT findings were ground-glass opacities (97.9%), crazy-paving pattern (58.3%), and mixed pattern (18.8%). Rounded lung opacities were observed most frequently (70.8%). Other findings were cystic airspace changes (37.5%), vascular dilatation (35.4%), and the organizing pneumonia pattern (14.6%). The findings were frequently bilateral (87.5%), symmetrical (68.9%), and peripheral (60.2%). CONCLUSIONS: The most common CT findings were ground-glass opacities and the crazy-paving pattern. Involvement was mostly bilateral, symmetrical, and peripheral. Round opacity morphology was frequently observed and might have some degree of specificity to viral COVID-19 pneumonia.

Detection of porcine reproductive and respiratory syndrome virus in oral fluid from naturally infected pigs in a breeding herd

The objectives of the present study were to evaluate the anatomic localization of porcine reproductive and respiratory syndrome virus (PRRSV) in naturally infected pigs and to determine whether oral fluid could be used to detect the virus in infected animals. Two sows, seven 2-month-old grower pigs, and 70 6-month-old gilts were included in this study. PRRSV in sera and oral fluid were identified by nested reverse transcription PCR (nRT-PCR) while lung, tonsil, and tissue associated with oral cavity were subjected to nRT-PCR, immunohistochemistry, and in situ hybridization. In sows, PRRSV was identified in oral fluid and tonsils. PRRSV was also detected in oral fluid, tonsils, salivary glands, oral mucosa, and lungs of all seven grower pigs. However, viremia was observed in only two grower pigs. Double staining revealed that PRRSV was distributed in macrophages within and adjacent to the tonsillar crypt epithelium. In gilts, the North American type PRRSV field strain was detected 3 to 8 weeks after introducing these animals onto the farm. These results confirm previous findings that PRRSV primarily replicates in tonsils and is then shed into oral fluid. Therefore, oral fluid sampling may be effective for the surveillance of PRRSV in breeding herds.

Genetic diversity of porcine reproductive and respiratory syndrome virus in Korea

The high genetic diversity of porcine reproductive and respiratory syndrome virus (PRRSV) has been an obstacle to developing an effective vaccine for porcine reproductive and respiratory syndrome (PRRS). This study was performed to assess the degree of genetic diversity among PRRSVs from Korean pig farms where wasting and respiratory syndrome was observed from 2005 to 2009. Samples from 786 farms were tested for the presence of PRRSV using reverse transcription PCR protocol. A total of 117 farms were positive for type 1 PRRSV while 198 farms were positive for type 2. Nucleotide sequences encoding the open reading frame (ORF) 5 were analyzed and compared to those of various published PRRSV isolates obtained worldwide. Sequence identity of the ORF 5 in the isolates was 81.6~100% for type 1 viruses and 81.4~100% for type 2 viruses. Phylogenetic analysis of the ORF 5 sequences showed that types 1 and 2 PRRSVs from Korea were mainly classified into three and four clusters, respectively. The analyzed isolates were distributed throughout the clusters independent of the isolation year or geographical origin. In conclusion, our results indicated that the genetic diversity of PRRSVs from Korean pig farms is high and has been increasing over time.

Isolation and characterization of a pandemic H1N1 influenza virus in pigs in Brazil / Isolamento e caracterização do vírus da influenza pandêmico H1N1 em suínos no Brasil

Influenza A virus (IAV) infections are endemic in pork producing countries around the world. The emergence of the pandemic 2009 human H1N1 influenza A virus (pH1N1) raised questions about the occurrence of this virus in Brazilian swine population. During a 2009-2010 swine influenza virus research project at Embrapa Swine and Poultry (CNPSA), an outbreak of a highly transmissible H1N1 influenza A virus disease was detected in a pig herd in Santa Catarina State, Brazil. The virus caused a mild disease in growing pigs and sows without mortality. Three clinically affected piglets were euthanized. Gross lesions included mild to moderate consolidation of cranioventral areas of the lung. Microscopically, the lesions were characterized by necrotizing obliterative bronchiolitis and bronchointerstitial pneumonia. Immunohistochemistry using a monoclonal antibody against type A influenza virus nucleoprotein revealed positive staining in the nuclei of the bronchiolar epithelial cells. Lung tissue from three piglets and nasal swabs from five sows and four piglets were positive for influenza A by RT-PCR. Influenza virus was isolated from one lung, later confirmed by the hemagglutination test (HA titer 1:128) and RT-PCR. Sequence analyses of Hemmaglutinin (HA) and Matrix (M) genes revealed that the virus was consistent with the pandemic (A/H1N1) 2009 influenza virus strain that circulated in humans. This is the first report of an outbreak of pandemic A/H1N1 influenza virus in pigs in Brazil.

A infecção causada pelo vírus Influenza A (IAV) é endêmica em suínos no mundo inteiro. O surgimento da pandemia de influenza humana pelo vírus A/H1N1 (pH1N1) em 2009 levantou dúvidas sobre a ocorrência deste vírus em suínos no Brasil. Durante o desenvolvimento de um projeto de pesquisa do vírus de influenza suína em 2009-2010, na Embrapa Suínos e Aves (CNPSA), foi detectado em um rebanho de suínos em Santa Catarina, Brasil, um surto de influenza altamente transmissível causado pelo subtipo viral H1N1. Este vírus causou uma doença leve em suínos em crescimento e em fêmeas adultas, sem mortalidade. Tres leitões clinicamente afetados foram eutanasiados. As lesões macroscópicas incluiam consolidação leve a moderada das áreas cranioventrais do pulmão. Microscopicamente, as lesões foram caracterizadas por bronquiolite necrosante obliterativa e pneumonia broncointersticial. A imunohistoquímica, utilizando um anticorpo monoclonal contra a nucleoproteína do vírus influenza A, revelou marcação positiva no núcleo das células epiteliais bronquiolares. O tecido pulmonar de três leitões e os suabes nasais de cinco fêmeas e quatro leitões foram positivos para influenza A pela RT-PCR. O vírus influenza foi isolado de um pulmão, mais tarde sendo confirmado pelo teste de hemaglutinação (título HA 1:128) e por RT-PCR. A análise das seqüências de nucleotídeos dos genes da hemaglutinina (HA) e proteína da matriz (M) revelou que o vírus isolado foi consistente com o vírus pandêmico A/H1N1/2009 que circulou em humanos no mesmo período. Este é o primeiro relato de um surto de influenza causado pelo vírus pandêmico A/H1N1 em suínos no Brasil.

Experimental infection of chickens, ducks and quails with the highly pathogenic H5N1 avian influenza virus

Highly pathogenic avian influenza viruses (HPAIV) of the H5N1 subtype have spread since 2003 in poultry and wild birds in Asia, Europe and Africa. In Korea, the highly pathogenic H5N1 avian influenza outbreaks took place in 2003/2004, 2006/2007 and 2008. As the 2006/2007 isolates differ phylogenetically from the 2003/2004 isolates, we assessed the clinical responses of chickens, ducks and quails to intranasal inoculation of the 2006/2007 index case virus, A/chicken/Korea/IS/06. All the chickens and quails died on 3 days and 3-6 days post-inoculation (DPI), respectively, whilst the ducks only showed signs of mild depression. The uninoculated chickens and quails placed soon after with the inoculated flock died on 5.3 and 7.5 DPI, respectively. Both oropharyngeal and cloacal swabs were taken for all three species during various time intervals after inoculation. It was found that oropharyngeal swabs showed higher viral titers than in cloacal swabs applicable to all three avian species. The chickens and quails shed the virus until they died (up to 3 to 6 days after inoculation, respectively) whilst the ducks shed the virus on 2-4 DPI. The postmortem tissues collected from the chickens and quails on day 3 and days 4-5 and from clinically normal ducks that were euthanized on day 4 contained the virus. However, the ducks had significantly lower viral titers than the chickens or quails. Thus, the three avian species varied significantly in their clinical signs, mortality, tissue virus titers, and duration of virus shedding. Our observations suggest that duck and quail farms should be monitored particularly closely for the presence of HPAIV so that further virus transmission to other avian or mammalian hosts can be prevented.

Vírus rábico em morcego Nyctinomops laticaudatus na Cidade do Rio de Janeiro, RJ: isolamento, titulação e epidemiologia / Rabies virus in Nyctinomops laticaudatus bats in the City of Rio de Janeiro: isolation, titration and epidemiology

Apresenta-se o primeiro relato de raiva em morcego da espécie Nyctinomops laticaudatus, na Cidade do Rio de Janeiro, RJ. Foram realizados isolamento e titulação viral em diferentes tecidos, encontrando-se altos títulos no cérebro e glândulas salivares. A ocorrência de raiva em uma espécie pouco freqüente neste estado sugere que a doença pode ser mais prevalente do que aparenta.

The first case report of rabies in bats of the species Nyctinomops laticaudatus, in the city of Rio de Janeiro City, is presented. Virus isolation and titration were performed in different tissues, and high titers were found in the brain and salivary glands. Rabies occurrence in such an infrequent species in this state suggests that the disease may be more prevalent than it appears to be.

Histopathological and ultrastructural aspects of mice lungs experimentally infected with dengue virus serotype 2

Histological and ultrastructural alterations in lung tissue of BALB/c mice infected with dengue virus serotype 2 (non-neuroadapted), by intraperitoneal and intravenous routes were analyzed. Lung tissues were processed following the standard techniques for photonic and electron transmission microscopies. Histopathological and ultrastructural studies showed interstitial pneumonia, characterized by the presence of mononuclear cells. In the mouse model, the dengue virus serotype 2 seems to led to a transient inflammatory process without extensive damage to the interalveolar septa, but caused focal alterations of the blood-exchange barrier. Endothelial cells of blood capillaries exhibited phyllopodia suggesting activation by presence of dengue virus. Morphometrical analysis of mast cells showed an expressive increase of the number of these cells in peribronchiolar spaces and adjacent areas to the interalveolar septa. Alveolar macrophages showed particles dengue virus-like inside rough endoplasmic reticulum and Golgi complex, suggesting viral replication. The tissue alterations observed in our experimental model were similar to the observed in human cases of dengue fever and dengue hemorrhagic fever. Our results show that BALB/c mice are permissive host for dengue virus serotype 2 replication and therefore provides an useful model to study of morphological aspects of dengue virus infection.

Morphological studies in a model for dengue-2 virus infection in mice

One of the main difficulties in studying dengue virus infection in humans and in developing a vaccine is the absence of a suitable animal model which develops the full spectrum of dengue fever, dengue haemorrhagic fever, and dengue shock syndrome. It is our proposal to present morphological aspects of an animal model which shows many similarities with the dengue infection in humans. BALB/c mice were intraperitoneally infected with non-neuroadapted dengue virus serotype 2 (DENV-2). Histopathological and morphometrical analyses of liver tissue revealed focal alterations along the infection, reaching wide-ranging portal and centrolobular veins congestion and sinusoidal cell death. Additional ultrastructural observations demonstrated multifocal endothelial injury, platelet recruitment, and alterated hepatocytes. Dengue virus antigen was detected in hepatocytes and in the capillar endothelium of the central lobular vein area. Liver function tests showed high levels of aspartate transaminase and alanine transaminase enzyme activity. Lung tissue showed interstitial pneumonia and mononuclear cells, interseptal oedema, hyperplasia, and hypertrophy of the bronchiolar epithelial cells. DENV-2 led to a transient inflammatory process, but caused focal alterations of the blood-exchange barrier. Viremia was observed from 2nd to 11th day p.i. by isolation of DENV-2 in C6/36 mosquito cell line inoculated with the supernatant of macerated liver, lung, kidney, and cerebellum tissues of the infected mice.

Experimental study of mouse cytomegalovirus infected mice / 华中科技大学学报（医学）（英德文版）

In order to investigate the human cytomegalovirus (HCMV) infection, the mouse cytomegalovirus (MCMV) infected mice were experimentally studied. 6 to 8 week old female BALB/C mice with immunosuppression were selected to undergo the MCMV inoculations: intracranial inoculation and peritoneal inoculation. MCMV of the infected mice in various organs and tissues were detected by using beta-gal staining and in situ nucleic acid hybridization assay. The pathological changes were observed in HE staining paraffin-embedded sections. It was found that all the MCMV infected mice showed the retardation of growth and development, and feather looseness. Both intracranial inoculation of 10(4) PFU viruses or peritoneal inoculation of 10(6) PFU viruses resulted in the pathological changes, to some extent, of various organs and tissues in the mice. The pathological changes in liver were consistent with the amount of beta-gal staining positive cells, indicating the liver lesions were mainly caused by viral proliferation. It was also found that the viruses in the immunosuppressed mice subjected to intracranial inoculation could spread to whole body organs, while the viruses in the immunosuppressed mice subjected to intrapeitoneal inoculation couldn't spread to the brain, suggesting blood-brain barrier could prevent the virus from spreading to the brain.