TY - JOUR AU - Martines, Roosecelis AU - Ritter, Jana AU - Matkovic, Eduard AU - Gary, Joy AU - Bollweg, Brigid AU - Bullock, Hannah AU - Goldsmith, Cynthia AU - Silva-Flannery, Luciana AU - Seixas, Josilene AU - Reagan-Steiner, Sarah AU - Uyeki, Timothy AU - Denison, Amy AU - Bhatnagar, Julu AU - Shieh, Wun-Ju AU - Zaki, Sherif T1 - Pathology and Pathogenesis of SARS-CoV-2 Associated with Fatal Coronavirus Disease, United States T2 - Emerging Infectious Disease journal PY - 2020 VL - 26 IS - 9 SP - 2005 SN - 1080-6059 AB - An ongoing pandemic of coronavirus disease (COVID-19) is caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Characterization of the histopathology and cellular localization of SARS-CoV-2 in the tissues of patients with fatal COVID-19 is critical to further understand its pathogenesis and transmission and for public health prevention measures. We report clinicopathologic, immunohistochemical, and electron microscopic findings in tissues from 8 fatal laboratory-confirmed cases of SARS-CoV-2 infection in the United States. All cases except 1 were in residents of long-term care facilities. In these patients, SARS-CoV-2 infected epithelium of the upper and lower airways with diffuse alveolar damage as the predominant pulmonary pathology. SARS-CoV-2 was detectable by immunohistochemistry and electron microscopy in conducting airways, pneumocytes, alveolar macrophages, and a hilar lymph node but was not identified in other extrapulmonary tissues. Respiratory viral co-infections were identified in 3 cases; 3 cases had evidence of bacterial co-infection. KW - SARS-CoV-2 KW - COVID-19 KW - coronavirus KW - pathology KW - histopathology KW - immunohistochemistry KW - electron microscopy KW - diffuse alveolar damage KW - respiratory infections KW - viruses KW - 2019 novel coronavirus disease KW - severe acute respiratory syndrome coronavirus 2 KW - zoonoses KW - coronavirus disease DO - 10.3201/eid2609.202095 UR - https://wwwnc.cdc.gov/eid/article/26/9/20-2095_article ER - End of Reference