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CASE REPORT article

Front. Med.

Sec. Infectious Diseases: Pathogenesis and Therapy

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1580570

Pathological features of explanted native lungs in a patient with end stage lung disease after resolution of severe COVID19 who underwent successful lung transplantation

Provisionally accepted
Wei  GuoWei Guo1,2Yan  LiuYan Liu3Minghuan  GeMinghuan Ge4Xiangchao  DingXiangchao Ding3Bo  WangBo Wang3Jian  XuJian Xu2Xiaoying  ChuXiaoying Chu2Ying  ChenYing Chen5Sufang  TianSufang Tian2*HUIQING  LINHUIQING LIN3*
  • 1Department of Pathology, Wuhan University School of Basic Medical Sciences, Wuhan, China
  • 2Department of Pathology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei Province, China
  • 3Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, China
  • 4Department of Urology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
  • 5CAS Key Laboratory of Special Pathogens, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China

The final, formatted version of the article will be published soon.

During the pandemic of COVID-19, lots of features of this disease have been discovered. However, the lung pathology and the correlated clinical features of the patients who recovered from the severe state of COVID-19 are still largely unknown. Especially for those who underwent diffuse alveolar damage (DAD), most of the morphological data were obtained from the autopsy specimens or biopsy samples. In the present report, the pathologic changes in the lungs of a patient who had successfully received lung transplantation at the recovery stage of severe COVID-19 were described. Diffuse alveolar damage, hyperplasia of interstitial fibroblast and alveolar type II epithelial cells, and the filling of macrophages in alveoli were observed. Hyperemia and thickening of blood vessels and interstitial lymphocytic inflammation were also prominent. SARS-COV-2 nuclear capsid was detected spotty in the alveolar epithelial after several times' negative nucleic acid results from his pharyngeal swab specimens. Evidence of combined virus infection, such as Cytomegalovirus, could also be found. A few eosinophils were found in the parenchymal of the lung, which combined with the elevated eosinophils in the blood, might indicate a recovery of this patient.This rare case provides a chance for us to observe the pathological changes in the diffuse fibrosis stage of severe COVID-19, which might help us to further understand how pulmonary fibrosis forms after severe pathogen infection.

Keywords: COVID-19, Diffuse pulmonary fibrosis, lymphocyte infiltration, SARS-CoV2, Lung Transplantation

Received: 20 Feb 2025; Accepted: 04 Aug 2025.

Copyright: © 2025 Guo, Liu, Ge, Ding, Wang, Xu, Chu, Chen, Tian and LIN. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Sufang Tian, Department of Pathology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei Province, China
HUIQING LIN, Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, China

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