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Table 4 Pulmonary pathology of COVID-19, SARS, and MERS

From: From SARS and MERS to COVID-19: a brief summary and comparison of severe acute respiratory infections caused by three highly pathogenic human coronaviruses

  COVID-19[144,145,146,147,148,149] SARS[55, 150,151,152,153,154] MERS [13, 155,156,157,158]
Gross examination Diffuse congestions with partly hemorrhagic necrosis Edematous lungs with diffuse congestion, enlarge pulmonary hila lymph nodes, irregular and patchy consolidation areas Edematous lungs with consolidation
Microscopic manifestation Main abnormalities: 1. Early-stage: exudative DAD without hyaline membrane formation; 2. Advanced-stage: DAD with hyaline membrane formation;
Others: pleural effusion and adhesion, mucous plugs formation, macrophages, neutrophils and lymphocytes infiltration; microvascular injury (microthrombi)
Main abnormalities: 1. Acute-period: acute exudative DAD (extensive edema and hyaline membrane formation, alveolar epithelial cells impairment, alveoli collapse, and fibrous tissue in alveolar spaces); 2. Progress-period: Combination of acute exudative DAD and proliferative DAD (fibrinous interstitial and airspace and hyperplastic pneumocytes);
Others: intravascular microthrombi
Main abnormalities: Acute exudative DAD with focal hemorrhagic necrotizing pneumonia (dispersed necrotic debris);
Others: NA
Superinfection Bacteria Bacteria, fungi, viruses NA
  1. NA not available