PMC:7543426 / 6771-20816 JSONTXT 11 Projects

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Id Subject Object Predicate Lexical cue
T60 0-7 Sentence denotes RESULTS
T61 9-58 Sentence denotes Patient Demographics and Clinical Characteristics
T62 59-202 Sentence denotes Table 1 and Table 2 depict the demographic and clinical characteristics of 22 COVID-19 patients on whom postmortem examinations were performed.
T63 203-269 Sentence denotes Of these, 18 had other medical comorbidities (designated group 1).
T64 270-419 Sentence denotes Four patients were healthy prior to hospital admission and had no known medical comorbidities or any cause of immunosuppression (designated group 2).
T65 420-428 Sentence denotes Table 1.
T66 430-473 Sentence denotes Summary of Patient Demographics at Baseline
T67 474-547 Sentence denotes Characteristic Group 1 With Comorbidities Group 2 Without Comorbidities
T68 548-573 Sentence denotes Number of patients 18 4
T69 574-584 Sentence denotes Demography
T70 585-655 Sentence denotes  Age, y, median ± SD (range) 76 ± 15.7 (27–92) 48.5 ± 13.07 (35–65)
T71 656-679 Sentence denotes  Men 12 (66.7) 3 (75)
T72 680-704 Sentence denotes  Women 6 (33.3) 1 (25)
T73 705-716 Sentence denotes Comorbidity
T74 717-768 Sentence denotes  Chronic obstructive pulmonary disease 6 (33.3) …
T75 769-798 Sentence denotes  Cardiac disease 8 (44.5) …
T76 799-823 Sentence denotes  Malignancy 5 (27.8) …
T77 824-850 Sentence denotes  Hypertension 4 (22.3) …
T78 851-873 Sentence denotes  Diabetes 4 (22.3) …
T79 874-900 Sentence denotes  Schizophrenia 1 (5.6) …
T80 901-929 Sentence denotes  Kidney disease 2 (11.2) …
T81 930-970 Sentence denotes Data are No. (%) except where indicated.
T82 971-979 Sentence denotes Table 2.
T83 981-1063 Sentence denotes Demographics, Comorbidities, Duration of Hospital Stay, and Autopsy Cause of Death
T84 1064-1191 Sentence denotes Patient Number Sex, M/F Age, y Onset of Symptoms, d Comorbidities Days in Hospital Before Death Postmortem Cause of Death
T85 1192-1338 Sentence denotes 1 M 81 Not known Hypertension Aortomyocardial sclerosis Ischemic heart disease Cardiomyopathy Aortic aneurysm 4 Cardiorespiratory failure
T86 1339-1487 Sentence denotes 2 F 82 Not known Diabetes Atrioventricular valve prothesis Atrial fibrillation COPD Malignancy Kidney disease 3 Cardiorespiratory failure
T87 1488-1535 Sentence denotes 3 M 92 7 COPD 1 Cardiorespiratory failure
T88 1536-1601 Sentence denotes 4 F 69 Not known Schizophrenia 28 Cardiorespiratory failure
T89 1602-1693 Sentence denotes 5 F 80 Not known Cardiovascular disease Senile dementia 38 Cardiorespiratory failure
T90 1694-1773 Sentence denotes 6 M 92 Not known Cardiovascular disease COPD 3 Cardiorespiratory failure
T91 1774-1827 Sentence denotes 7 F 64 4 Malignancy 2 Cardiorespiratory failure
T92 1828-1907 Sentence denotes 8 M 58 Not known Pulmonary artery thrombosis 4 Cardiorespiratory failure
T93 1908-1973 Sentence denotes 9 M 64 Not known Myelodysplasia 4 Cardiorespiratory failure
T94 1974-2039 Sentence denotes 10 M 82 3 Aortic aneurysm COPD 5 Cardiorespiratory failure
T95 2040-2103 Sentence denotes 11 M 76 Not known Malignancy 30 Cardiorespiratory failure
T96 2104-2214 Sentence denotes 12 M 60 6 Malignancy Hypertension Kidney disease Diabetes COPD Obesity 29 Cardiorespiratory failure
T97 2215-2322 Sentence denotes 13 F 70 Not known Cardiovascular disease Diabetes Psychiatric disorder 43 Cardiorespiratory failure
T98 2323-2430 Sentence denotes 14 M 76 Not known Malignancy COPD Hypertension Cardiovascular disease 33 Cardiorespiratory failure
T99 2431-2496 Sentence denotes 15 F 27 Not known HIV infection 6 Cardiorespiratory failure
T100 2497-2630 Sentence denotes 16 M 82 Not known Parkinson disease Hypertension Transient ischemic attack Prostate hypertrophy 14 Cardiorespiratory failure
T101 2631-2691 Sentence denotes 17 M 57 Not known Diabetes 1 Cardiorespiratory failure
T102 2692-2847 Sentence denotes 18 M 86 Not known Endocarditis caused by Staphylococcus aureus Prostate hypertrophy Aortic aneurysm Atrial fibrillation 1 Cardiorespiratory failure
T103 2848-2897 Sentence denotes 19 M 54 4 NONE 16 Cardiorespiratory failure
T104 2898-2946 Sentence denotes 20 M 35 5 NONE 7 Cardiorespiratory failure
T105 2947-2996 Sentence denotes 21 M 65 7 NONE 12 Cardiorespiratory failure
T106 2997-3054 Sentence denotes 22 F 43 Not known NONE 25 Cardiorespiratory failure
T107 3055-3113 Sentence denotes Abbreviation: COPD, chronic obstructive pulmonary disease.
T108 3115-3150 Sentence denotes Autopsy and Microscopic Examination
T109 3152-3165 Sentence denotes Lung Findings
T110 3167-3188 Sentence denotes Macroscopic Findings.
T111 3189-3323 Sentence denotes Lungs from all patients were increased in volume, firm, edematous, and congested with diffuse pleural thickening and pleural effusion.
T112 3324-3466 Sentence denotes Cut surface showed consolidation of lobes and red congested areas, with thickening of the interstitial septa and pulmonary edema (Figure 1A1).
T113 3467-3519 Sentence denotes Subsegmental pulmonary embolism was seen in 5 cases.
T114 3520-3529 Sentence denotes Figure 1.
T115 3531-3561 Sentence denotes Pathological findings in lung.
T116 3562-3641 Sentence denotes A1, Lungs showed an increase in volume and were firmer and heavier than normal.
T117 3642-3834 Sentence denotes A2 and A3, Light microscopic analysis shows parenchymal multifocal damage with intraalveolar inflammation, fibrin, and hyaline membranes consistent with a diagnosis of diffuse alveolar damage.
T118 3835-3920 Sentence denotes Both acute exudative inflammatory process and fibrous proliferative phase were found.
T119 3921-4064 Sentence denotes A3 and A4, Hyperplasia of type II pneumocyte, characterized by amphophilic cytoplasm, large nuclei, and prominent nucleoli, are shown (arrows).
T120 4065-4092 Sentence denotes B1, Alveolar duct fibrosis.
T121 4093-4127 Sentence denotes B2, Fibrin thrombi in capillaries.
T122 4128-4195 Sentence denotes B3, Vascular injury including vessel vasculitis and vascular edema.
T123 4196-4217 Sentence denotes B4, Pleural fibrosis.
T124 4218-4260 Sentence denotes Abbreviation: H&E, haematoxylin and eosin.
T125 4261-4307 Sentence denotes Scale bars: A2, 14 µm; A3–B3, 7 µm; B4, 21 µm.
T126 4309-4330 Sentence denotes Microscopic Findings.
T127 4331-4393 Sentence denotes A range of common lung findings were seen on light microscopy.
T128 4394-4607 Sentence denotes Parenchymal multifocal damage with intraalveolar exudative and proliferative inflammation (Figure 1A2), with fibrin, hyaline membranes (Figure 1A3) consistent with a diagnosis of diffuse alveolar damage (Table 3).
T129 4608-4813 Sentence denotes Organizing pneumonia with fibrosis and type II pneumocyte hyperplasia, amphophilic cytoplasm, large nuclei, and prominent nucleoli, were indicative of cytopathic virus-induced changes (Figure 1A3 and 1A4).
T130 4814-4958 Sentence denotes Fibroblastic foci consisting of loose organizing connective tissue reflective of alveolar duct fibrosis were seen (fibrotic phase) (Figure 1B1).
T131 4959-5086 Sentence denotes Other findings included: pleural fibrosis (Figure 1B4), vascular injury with thrombi (Figure 1B2), and vasculitis (Figure 1B3).
T132 5087-5395 Sentence denotes A main feature was the presence of numerous inflammatory cells consisting of granulocytes (CD15+) (Supplementary Figure 1A1 and 1A2), macrophages (CD68+) (Supplementary Figure 1A3 and 1A4), and T lymphocytes (CD3+) infiltrating into alveolar septa and clustering around capillary vessels (Supplementary 1B1).
T133 5396-5508 Sentence denotes Immunohistochemistry showed the presence of both CD4+ and CD8+ T lymphocytes (Supplementary Figure 1B2 and 1B3).
T134 5509-5593 Sentence denotes Of note, lymphocytes were CD20− indicating an absence of infiltrating B lymphocytes.
T135 5594-5744 Sentence denotes Thrombi were present and immunohistochemistry showed the presence of platelet aggregates and megakaryocytes within thrombi (Supplementary Figure 1B4).
T136 5745-5753 Sentence denotes Table 3.
T137 5755-5778 Sentence denotes Histopathology Findings
T138 5779-5840 Sentence denotes Findings Group 1, No. (%) (n = 18) Group 2, No. (%) (n = 4)
T139 5841-5845 Sentence denotes Lung
T140 5846-5884 Sentence denotes  Hyaline membranes 8 (44.4) 2 (50.0)
T141 5885-5939 Sentence denotes  Hyperplasia of type II pneumocyte 11 (61.2) 4 (100)
T142 5940-5973 Sentence denotes  Alveolar plug 8 (44.4) 4 (100)
T143 5974-6018 Sentence denotes  Alveolar fibrin deposit 9 (50.0) 3 (75.0)
T144 6019-6051 Sentence denotes  Hemorrhage 10 (55.6) 2 (50.0)
T145 6052-6091 Sentence denotes  Inflammatory cells 13 (72.3) 4 (100)
T146 6092-6153 Sentence denotes  Diffuse alveolar damage, fibrotic phase 12 (66.7) 1 (25.0)
T147 6154-6188 Sentence denotes  Microthrombi 14 (77.8) 2 (50.0)
T148 6189-6219 Sentence denotes  Vasculitis 8 (44.4) 4 (100)
T149 6220-6267 Sentence denotes  Multinucleated giant cells 4 (22.3) 2 (50.0)
T150 6268-6275 Sentence denotes Cardiac
T151 6276-6308 Sentence denotes  Myocarditis 9 (50.0) 3 (75.0)
T152 6309-6340 Sentence denotes  Vasculitis 5 (27.8) 3 (75.0)
T153 6341-6386 Sentence denotes  Inflammatory infiltrate 13 (72.3) 3 (75.0)
T154 6387-6422 Sentence denotes  Focal necrosis 6 (33.4) 2 (50.0)
T155 6423-6455 Sentence denotes  Pericarditis 9 (50.0) 4 (100)
T156 6456-6494 Sentence denotes  Vascular fibrosis 4 (22.3) 2 (50.0)
T157 6495-6502 Sentence denotes Hepatic
T158 6503-6547 Sentence denotes  Inflammatory infiltrate 8 (44.4) 3 (75.0)
T159 6548-6579 Sentence denotes  Congestion 8 (44.4) 2 (50.0)
T160 6580-6610 Sentence denotes  Steatosis 9 (50.0) 3 (75.0)
T161 6611-6616 Sentence denotes Renal
T162 6617-6661 Sentence denotes  Inflammatory infiltrate 9 (50.0) 3 (75.0)
T163 6662-6701 Sentence denotes  Glomerulosclerosis 9 (50.0) 3 (75.0)
T164 6702-6743 Sentence denotes  Interstitial fibrosis 9 (50.0) 4 (100)
T165 6744-6751 Sentence denotes Splenic
T166 6752-6791 Sentence denotes  Congested red pulp 15 (83.4) 4 (100)
T167 6792-6832 Sentence denotes  Lymphoid hypoplasia 11 (61.2) 4 (100)
T168 6833-6844 Sentence denotes Bone marrow
T169 6845-6885 Sentence denotes  Megakaryocytes hyperplasia 0 2 (50.0)
T170 6886-6917 Sentence denotes  Adipocytes 7 (38.9) 1 (25.0)
T171 6919-6949 Sentence denotes Immunohistochemistry Findings.
T172 6950-7134 Sentence denotes T-cell activation is modulated by dipeptidyl peptidase-4 (DPP4) [16] and thus the expression of CD26/DPP4 and CXCR3/CD183 was analyzed on lung tissues from group 2 patients (Figure 2).
T173 7135-7273 Sentence denotes Numerous CD26+ cells were found in the alveolar septa (Figure 2A1–2A3) with intense staining seen in the type II pneumocytes (Figure 2A3).
T174 7274-7371 Sentence denotes Positive cells entrapped with fibrin clots in the vascular lumen were also observed (Figure 2A4).
T175 7372-7563 Sentence denotes CXCR3 immunostaining showed lymphocytes localized in inflammatory perivascular aggregates (Figure 2B1, 2B2, and 2B4) which spread into alveolar septa and alveolar spaces (Figure 2B2 and 2B3).
T176 7564-7573 Sentence denotes Figure 2.
T177 7575-7626 Sentence denotes Immunohistological characterization of lung tissue.
T178 7627-7688 Sentence denotes A1–A4, CD26/dipeptidyl peptidase-4 expression in lung tissue.
T179 7689-7759 Sentence denotes Numerous strongly positive CD26+ cells are seen in the alveolar septa.
T180 7760-7825 Sentence denotes A3, Intense staining is seen in the type II pneumocytes (arrows).
T181 7826-7903 Sentence denotes A4, Positive cells are also seen entrapped with fibrin in the vascular lumen.
T182 7904-8081 Sentence denotes B1–B4, CXCR3/CD183 immunostaining shows intense staining of lymphocytes localized in the inflammatory perivascular aggregates and spread into alveolar septa and alveolar spaces.
T183 8082-8157 Sentence denotes Scale bars: A1 and B1, 100 µm; A2, A3, and B4, 7 µm; A4, B2, and B3, 14 µm.
T184 8159-8189 Sentence denotes Electron Microscopic Findings.
T185 8190-8344 Sentence denotes SARS-CoV-2 particles were detected within type II pneumocytes, which showed degenerating features characterized by fine and uniformly dispersed chromatin.
T186 8345-8455 Sentence denotes These pneumocytes displayed swollen mitochondrial profiles and dilated rough endoplasmic reticulum (Figure 3).
T187 8456-8569 Sentence denotes Numerous virus-containing compartments (VCC) of different sizes and shapes were detected (Figure 3A, 3B, and 3D).
T188 8570-8689 Sentence denotes Interestingly, spherules, very small vesicles containing single viral particles (Figure 3B and 3C), were also observed.
T189 8690-8699 Sentence denotes Figure 3.
T190 8701-8773 Sentence denotes SARS-CoV-2 detection in lung tissue by transmission electron microscopy.
T191 8774-8875 Sentence denotes A, SARS-CoV-2 particles are visible in virus-containing compartments in type II pneumocytes (arrows).
T192 8876-8955 Sentence denotes B–D, Numerous viral particles are enclosed in single-membrane vacuoles (arrow).
T193 8956-9027 Sentence denotes Other, very small vesicles contain single viral particles (arrowheads).
T194 9028-9060 Sentence denotes Scale bars: A, 1 µm; B–D, 200nm.
T195 9062-9076 Sentence denotes Heart Findings
T196 9078-9099 Sentence denotes Macroscopic Findings.
T197 9100-9244 Sentence denotes The hearts in all group 1 and 2 patients showed increased size and weight, hypertrophy, and dilation of the left and right atria and ventricles.
T198 9245-9354 Sentence denotes The myocardium appeared pale and flabby, and endocardium showed punctuate petechial hemorrhages (Figure 4A1).
T199 9355-9444 Sentence denotes Some patients in group 1 had pathological changes that were related to the patient’s age.
T200 9445-9637 Sentence denotes These included myocardial ischemic or inflammatory changes, hypertensive changes of the left ventricular cavity, and valvular calcification of the mitral annulus and aortic valve (Figure 4A2).
T201 9638-9647 Sentence denotes Figure 4.
T202 9649-9679 Sentence denotes Histological changes in heart.
T203 9680-9725 Sentence denotes A1, Hearts were increased in size and weight.
T204 9726-9766 Sentence denotes The myocardium appeared pale and flabby.
T205 9767-9818 Sentence denotes Endocardium showed punctuate petechial hemorrhages.
T206 9819-10044 Sentence denotes A2, Age-related disease of the heart was represented by volume changes of the left ventricular cavity and exacerbated by systemic hypertension with valve changes including calcification of the mitral annulus and aortic valve.
T207 10045-10203 Sentence denotes A3 and A4, Heart tissue shows myocytes hypertrophy, and variable degrees of interstitial and vascular fibrosis with mononuclear cells infiltrating adventitia.
T208 10204-10344 Sentence denotes B1, Active myocarditis was characterized by mononuclear, predominantly lymphocytic infiltrate, associated with focal myocytes necrosis (B2).
T209 10345-10415 Sentence denotes B3, Fibrinous, hemorrhagic areas with myofibers disarray were present.
T210 10416-10519 Sentence denotes B4, Pericarditis with lymphocytic infiltration and increase in fibrous tissue was seen in all patients.
T211 10520-10562 Sentence denotes Abbreviation: H&E, haematoxylin and eosin.
T212 10563-10615 Sentence denotes Scale bars: A3 and B4, 21 µm; A4–B2,7 µm; B3, 14 µm.
T213 10617-10638 Sentence denotes Microscopic Findings.
T214 10639-10773 Sentence denotes Microscopic changes seen were hypertrophy of myocytes and variable degrees of interstitial and vascular fibrosis (Figure 4A3 and 4A4).
T215 10774-10873 Sentence denotes Mononuclear cells infiltrating adventitia was found predominantly in group 2 patients (Figure 4A4).
T216 10874-11107 Sentence denotes Active myocarditis (Figure 4B1) characterized by mononuclear, predominantly lymphocytic, infiltrate, and was associated with focal myocytes necrosis (Figure 4B2), fibrinous, and hemorrhagic areas with myofibers disarray (Figure 4B3).
T217 11108-11193 Sentence denotes Pericarditis (fibrinous or fibrous) was seen mainly in group 2 patients (Figure 4B4).
T218 11195-11242 Sentence denotes Liver, Kidney, Spleen, and Bone Marrow Findings
T219 11244-11250 Sentence denotes Liver.
T220 11251-11332 Sentence denotes Macroscopic inspection of the liver of all patients showed parenchyma congestion.
T221 11333-11619 Sentence denotes The main findings at histological level were sinusoidal congestion and extravasation of red blood cells into the space of Disse (Figure 5A1) and in a few cases this was associated with congestion of small veins and hepatocyte necrosis (Figure 5A2 and 5A3) and infiltration (Figure 5A4).
T222 11620-11738 Sentence denotes Macrovacuolar and microvacuolar steatosis was seen mostly in group 2 patients (Figure 5A1, 5A2, and 5A4, and Table 3).
T223 11739-11748 Sentence denotes Figure 5.
T224 11750-11792 Sentence denotes Pathological findings in liver and kidney.
T225 11793-11899 Sentence denotes A1, Liver tissue shows sinusoidal congestion and extravasation of red blood cells into the space of Disse.
T226 11900-11982 Sentence denotes In some cases, small vein congestion (A2) and hepatic necrosis (A3) were reported.
T227 11983-12026 Sentence denotes A4, Inflammatory infiltration was observed.
T228 12027-12124 Sentence denotes A1, A2, and A4, Macrovacuolar and microvacuolar steatosis were observed in the majority of cases.
T229 12125-12178 Sentence denotes B1, Kidney glomerular endothelial cells were swollen.
T230 12179-12239 Sentence denotes B2, Fibrin deposit is visible underneath the Bowman capsule.
T231 12240-12320 Sentence denotes B3, Tubulointerstitial inflammation and (B4) glomerular sclerosis were observed.
T232 12321-12363 Sentence denotes Abbreviation: H&E, haematoxylin and eosin.
T233 12364-12419 Sentence denotes Scale bars: A1–A4, and B3, 50 µm; B1, B2, and B4, 14 µm
T234 12421-12428 Sentence denotes Kidney.
T235 12429-12513 Sentence denotes The kidneys of all patients generally had normal shape with reduced volume and size.
T236 12514-12556 Sentence denotes Outer surfaces showed reddish depressions.
T237 12557-12695 Sentence denotes Histological examination showed interstitial fibrosis, mainly in group 2 patients (Figure 5B1), with swollen glomerular endothelial cells.
T238 12696-12768 Sentence denotes Fibrin deposits were visible underneath the Bowman capsule (Figure 5B2).
T239 12769-12948 Sentence denotes Chronic tubular-interstitial inflammation (Figure 5B3) and glomerular sclerosis were observed (Figure 5B4) even in patients without a history of previous kidney disease (Table 3).
T240 12950-12957 Sentence denotes Spleen.
T241 12958-13031 Sentence denotes The spleens of all patients had normal shape but reduced volume and size.
T242 13032-13172 Sentence denotes The splenic white pulps of all 4 of the group 2 cases showed lymphoid hypoplasia with congested red pulp (Figure 6A1 and 6A2), and Table 3).
T243 13173-13182 Sentence denotes Figure 6.
T244 13184-13220 Sentence denotes Histology of spleen and bone marrow.
T245 13221-13289 Sentence denotes A1 and A2, Lymphoid hypoplasia is visible in the splenic white pulp.
T246 13290-13406 Sentence denotes B1 and B2, Bone marrows tissue shows replacement of red hematopoietic bone marrow with yellow adipocyte-rich marrow.
T247 13407-13454 Sentence denotes Megakaryocyte hyperplasia is observed (arrows).
T248 13455-13497 Sentence denotes Abbreviation: H&E, haematoxylin and eosin.
T249 13498-13556 Sentence denotes C1, Macrophages (CD68+) are present in bone marrow tissue.
T250 13557-13621 Sentence denotes C2, CD68+ cells displaying features of hemophagocytosis (arrow).
T251 13622-13666 Sentence denotes Scale bars: A1, A2, B2–C2, 7 µm; B1, 100 µm.
T252 13668-13680 Sentence denotes Bone Marrow.
T253 13681-13851 Sentence denotes Microscopic analysis of the bone marrows generally showed replacement of red hematopoietic bone marrow with yellow adipocyte-rich marrow in group 1 patients (Figure 6B1).
T254 13852-13936 Sentence denotes Megakaryocytes hyperplasia (Figure 6B2) was seen in 2 patients of group 2 (Table 3).
T255 13937-14045 Sentence denotes Numerous macrophages (CD68+) were seen and they displayed features of hemophagocytosis (Figure 6C1 and 6C2).