ABSTRACT
The COVID-19 pandemic is a worldwide problem. In most patients, the disease is mild, but in the elderly and those with comorbidities, including asthma, it tends to progress to pneumonia, acute respiratory distress syndrome, and multiple organ dysfunction. This article presents a clinical case. Materials and methods. The pathology description of the respiratory organs of a 65-year-old female, who was followed up for asthma and infected with COVID-19, is presented. Results. Histological examination showed signs of bilateral viral pneumonia and asthma: edema, vascular congestion, perivascular hemorrhages, and focal epithelial desquamation in the mucosa of large bronchi. Walls of small bronchi and bronchioles were thickened, with fibrous changes, infiltrated by lymphocytes, with focal basal membrane baring and signs of hypersecretion, increased number of goblet cells. Despite the absence of eosinophils, a large number of neutrophils, Charcot-Leyden crystals, Curschmann's spirals, creola bodies in the desquamated epithelium, there were signs of bronchospasm (circular displacement of cartilage plates and their overlapping, corrugation of epithelial layer in the form of «star» and perpendicular location of rounded bundles of muscle fibers). Pulmonary tissue slices showed signs of diffuse alveolar damage. In alveolar walls, areas of necrosis and desquamation of alveolar epithelium (scattered cells), with areas of hemorrhages, lymphocytic and mononuclear infiltration were observed. Conclusion. The clinical case presented incomplete correspondence of morphological changes in the lungs, typical for asthma (along with signs of bronchioles sclerosis, absence of marked eosinophilic-cell infiltration of bronchiolar mucosa). The risk of severe viral interstitial pneumonia with diffuse alveolar damage, severe alveolar hemorrhagic syndrome, and microcirculatory thrombosis is high in this category of patients. A combination of factors such as asthma and advanced age can aggravate the course of COVID-19. (English) [ FROM AUTHOR] ßрþñûõüþù üøрþòþóþ üðÑÂштðñð ÑÂòÃȄÂõтÑÂѠÿðýôõüøѠCOVID-19. ã ñþûьшøýÑÂтòð ÿðцøõýтþò ÷ðñþûõòðýøõ ÿрþтõúðõт ò ûõóúþù фþрüõ, þôýðúþ у ÿþöøûых ø ûøцѠÑÂþÿутÑÂтòующøüø ÷ðñþûõòðýøÑÂüø, ò тþü чøÑÂûõ Ѡñрþýхøðûьýþù ðÑÂтüþù, þýþ ÿрþóрõÑÂÑÂøруõт ôþ ÿýõòüþýøø, þÑÂтрþóþ рõÑÂÿøрðтþрýþóþ ôøÑÂтрõÑÂÑÂ-ÑÂøýôрþüð ø ÿþûøþрóðýýþù ôøÑÂфуýúцøø. æõûь рðñþты. ÞÿøÑÂðýøõ úûøýøчõÑÂúþóþ ÑÂûучðѠCOVID-19 у ÿðцøõýтúø ÑÂþ ÑÂüõшðýýþù фþрüþù ñрþýхøðûьýþù ðÑÂтüы, ÿрøòõôшõóþ ú ûõтðûьýþüу øÑÂхþôу. Ãœðтõрøðû ø üõтþôы. ßрþòõôõýþ üþрфþûþóøчõÑÂúþõ þÿøÑÂðýøõ þрóðýþò ôыхðýøѠтруÿð öõýщøýы 65 ûõт, ÑÂþÑÂтþÑÂщõù ýð ôøÑÂÿðýÑÂõрýþü учõтõ ò ÑÂòÑÂ÷ø Ѡñрþýхøðûьýþù ðÑÂтüþù ø øýфøцøрþòðýýþù òøруÑÂþü SARS-CoV-2. àõ÷уûьтðты. ßрø óøÑÂтþûþóøчõÑÂúþü øÑÂÑÂûõôþòðýøø òыÑÂòûõýы ÿрø÷ýðúø ôòуÑÂтþрþýýõù òøруÑÂýþù ÿýõòüþýøø ø ñрþýхøðûьýþù ðÑÂтüы: ò ÑÂûø÷øÑÂтþù þñþûþчúõ úруÿýых ñрþýхþò þÿрõôõÃȄÂûøÑÂÑŒ þтõú, ÿþûýþúрþòøõ ÑÂþÑÂуôþò, üõÑÂтðüø ÿõрøòðÑÂúуÃȄÂрýыõ úрþòþø÷ûøÑÂýøÑÂ, þчðóþòðѠôõÑÂúòðüðцøѠÑÂÿøтõûøÑÂ. áтõýúø üõûúøх ñрþýхþò ø ñрþýхøþû ñыûø утþûщõýы, ÑÂúûõрþ÷øрþòðýы, øýфøûьтрøрþòðýы ûøüфþцøтðüø, üõÑÂтðüø Ѡþóþûõýøõü ñð÷ðûьýþù üõüñрðýы ø ÿрø÷ýðúðüøóøÿõрÑÂõúрõцøø, уòõûøчõýýыü чøÑÂûþü ñþúðûþòøôýых úûõтþú. ÃÂõÑÂüþтрѠýð þтÑÂутÑÂтòøõ ò àûðÑÂтðх ÑÂûущõýýþóþ ÑÂÿøтõûøѠÑÂþ÷øýþфøûþò, ñþûьшþóþ úþûøчõÑÂтòð ýõùтрþфøûþò, úрøÑÂтðûûþò èðрúþ-Ûõùôõýð, ÑÂÿøрðûõù Úуршüðýð, тõûõцÚрõþûð, ýðñûюôðûøÑÂÑŒ ÿрø÷ýðúø ñрþýхþÑÂÿð÷üð (цøрúуÃȄÂрýþõ ÑÂüõщõýøõ Ñ…Ñ€ÑÂщõòых ÿûðÑÂтøýþú ø ÷ðхþöôõýøõ øх þôýð ÷ð ôруóую, óþфрøрþòðýýþÑÂÑ‚ÑŒ ÑÂÿøтõûøðûьýþóþ ÿûðÑÂтð ò òøôõ «Ã·Ã²ÃµÃ·Ã´Ã¾Ñ‡ÃºÃ¸Â» ø ÿõрÿõýôøúуÃȄÂрýþõ рðÑÂÿþûþöõýøõ þúруóûых ÿучúþò üышõчýых òþûþúþý). Ã’ ÑÂрõ÷ðх ûõóþчýþù тúðýø òыÑÂòûõýы ø÷üõýõýøѠÿþ тøÿу ôøффу÷ýþóþ ðûьòõþÃȄÂрýþóþ ÿþòрõöôõýøÑÂ. Ã’ ÑÂтõýúðх ðûьòõþû þтüõчõýы учðÑÂтúø ýõúрþ÷þò ø ôõÑÂúòðüðцøѠðûьòõþÃȄÂрýþóþ ÑÂÿøтõûøѠò òøôõ рð÷рþ÷ýõýýых úûõтþú, ѠучðÑÂтúðüø úрþòþø÷ûøÑÂýøù, ûøüфþцøтðрýþù ø üþýþýуúûõðрýþù øýфøûьтрðцøø. ×ðúûючõýøõ. Ã’ úûøýøчõÑÂúþü ÑÂûучðõ òыÑÂòûõýþ ýõÿþûýþõ ÑÂþþтòõтÑÂтòøõ üþрфþûþóøчõÑÂúøх ø÷üõýõýøù ò ûõóúøх, хðрðúтõрýых ôûѠñрþýхøðûьýþù ðÑÂтüы (ýðрÑÂôу Ѡÿрø÷ýðúðüø ñрþýхøþûþÑÂúûõрþ÷ð, þтÑÂутÑÂтòøõü ÑÂрúþ òырðöõýýþù ÑÂþ÷øýþфøûьýþ-úûõтþчýþù øýфøûьтрðцøø ÑÂûø÷øÑÂтþù þñþûþчúø ñрþýхøþÃȄÂрýþù ÑÂтõýúø). àøÑÂú рð÷òøтøѠтÑÂöõûþù òøруÑÂýþù øýтõрÑÂтøцøðûьýþù ÿýõòüþýøø Ѡôøффу÷ýыü ðûьòõþÃȄÂрýыü ÿþòрõöôõýøõü, Ѡòырðöõýýыü ðûьòõþÃȄÂрýþ-óõüþррðóøчõÑÂúøü ÑÂøýôрþüþü ø трþüñþ÷þü üøúрþцøрà уÃȄ тþрýþóþ руÑÂûð þÑÂтðõтÑÂѠòыÑÂþúøü у ôðýýþù úðтõóþрøø ÿðцøõýтþò. áþчõтðýøõ тðúøх фðúтþрþò, úðú ýðûøчøõ ñрþýхøðûьýþù ðÑÂтüы ø ÿþöøûþóþ òþ÷рðÑÂтð, òõрþÑÂтýþ, üþöõт уÑÂуóуñÃȄÂÑ‚ÑŒ тõчõýøõ COVID-19. (Russian) [ FROM AUTHOR] Copyright of Profilakticheskaya Meditsina is the property of Media Sphere Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
The corona virus outbreak in Wuhan, China, at the end of 2019 has rapidly evolved into a pandemic which is still virulent in many countries. An infection with SARS-CoV-2 can lead to corona virus disease (Covid-19). This paper presents an overview of the knowledge gained so far with regard to histopathological lung lesions in fatal courses of Covid-19. The main findings were diffuse alveolar damage and micro-angiopathies. These included the development of hyaline membranes, thrombi, endothelial inflammation, haemorrhages and angiogenesis. Overall, the vessel lesions seemed to be more lethal than the diffuse alveolar damage. There was obvious hyperreactivity and hyperinflammation of the cellular immune system. An expanded T-cell memory may explain the increased risk of a severe course in the elderly.