Premium
Histopathology of Middle East respiratory syndrome coronovirus ( MERS ‐CoV) infection – clinicopathological and ultrastructural study
Author(s) -
Alsaad Khaled O,
Hajeer Ali H,
Al Balwi Mohammed,
Al Moaiqel Mohammed,
Al Oudah Nourah,
Al Ajlan Abdulaziz,
AlJohani Sameera,
Alsolamy Sami,
Gmati Giamal E,
Balkhy Hanan,
AlJahdali Hamdan H,
Baharoon Salim A,
Arabi Yaseen M
Publication year - 2018
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.13379
Subject(s) - pathology , histopathology , kidney , lung , pneumonia , diffuse alveolar damage , medicine , tissue tropism , biology , virus , tropism , immunology , acute respiratory distress
Aims The pathogenesis, viral localization and histopathological features of Middle East respiratory syndrome – coronavirus ( MERS ‐CoV) in humans are not described sufficiently. The aims of this study were to explore and define the spectrum of histological and ultrastructural pathological changes affecting various organs in a patient with MERS ‐CoV infection and represent a base of MERS ‐CoV histopathology. Methods and results We analysed the post‐mortem histopathological findings and investigated localisation of viral particles in the pulmonary and extrapulmonary tissue by transmission electron microscopic examination in a 33‐year‐old male patient of T cell lymphoma, who acquired MERS ‐CoV infection. Tissue needle biopsies were obtained from brain, heart, lung, liver, kidney and skeletal muscle. All samples were collected within 45 min from death to reduce tissue decomposition and artefact. Histopathological examination showed necrotising pneumonia, pulmonary diffuse alveolar damage, acute kidney injury, portal and lobular hepatitis and myositis with muscle atrophic changes. The brain and heart were histologically unremarkable. Ultrastructurally, viral particles were localised in the pneumocytes, pulmonary macrophages, renal proximal tubular epithelial cells and macrophages infiltrating the skeletal muscles. Conclusion The results highlight the pulmonary and extrapulmonary pathological changes of MERS ‐CoV infection and provide the first evidence of the viral presence in human renal tissue, which suggests tissue trophism for MERS ‐CoV in kidney.