Evidence map›Paper›PMID 32542743›Full record

ArticleHistopathology2020

Diffuse alveolar damage (DAD) resulting from coronavirus disease 2019 Infection is Morphologically Indistinguishable from Other Causes of DAD.

Kristine E Konopka, Teresa Nguyen, Jeffrey M Jentzen, Omar Rayes, Carl J Schmidt, Allecia M Wilson, Carol F Farver, Jeffrey L Myers

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Histopathology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 123 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
123citing papers in PubMed, 13 pooled it
4.4field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

123 citing papers in PubMed, 13 syntheses or guidelines pooled it, 195 citations in OpenAlex.

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  8. Histopathological findings and clinicopathologic correlation in COVID-19: a systematic review.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2021
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  18. Natural SARS-CoV-2 infection in farmed minksFrontiers in veterinary science · 2026
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63 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Kristine E KonopkaDepartment of Pathology, University of Michigan, Ann Arbor, MI, USA.ORCID https://orcid.org/0000-0002-4582-0120
Teresa NguyenDepartment of Pathology, University of Michigan, Ann Arbor, MI, USA.
Jeffrey M JentzenDepartment of Pathology, University of Michigan, Ann Arbor, MI, USA.
Omar RayesDepartment of Pathology, University of Michigan, Ann Arbor, MI, USA.
Carl J SchmidtDepartment of Pathology, University of Michigan, Ann Arbor, MI, USA.
Allecia M WilsonDepartment of Pathology, University of Michigan, Ann Arbor, MI, USA.
Carol F FarverDepartment of Pathology, University of Michigan, Ann Arbor, MI, USA.
Jeffrey L MyersDepartment of Pathology, University of Michigan, Ann Arbor, MI, USA.
University of Michigan · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsDiffuse alveolar damage (DAD) is a ubiquitous finding in inpatient coronavirus disease 2019 (COVID-19)-related deaths, but recent reports have also described additional atypical findings, including vascular changes. An aim of this study was to assess lung autopsy findings in COVID-19 inpatients, and in untreated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive individuals who died in the community, in order to understand the relative impact of medical intervention on lung histology. Additionally, we aimed to investigate whether COVID-19 represents a unique histological variant of DAD by comparing the pathological findings with those of uninfected control patients. METHODS AND

resultsLung sections from autopsy cases were reviewed by three pulmonary pathologists, including two who were blinded to patient cohort. The cohorts included four COVID-19 inpatients, four cases with postmortem SARS-CoV-2 diagnoses who died in the community, and eight SARS-CoV-2-negative control cases. DAD was present in all but one SARS-CoV-2-positive patient, who was asymptomatic and died in the community. Although SARS-CoV-2-positive patients were noted to have more focal perivascular inflammation/endothelialitis than control patients, there were no significant differences in the presence of hyaline membranes, fibrin thrombi, airspace organisation, and 'acute fibrinous and organising pneumonia'-like intra-alveolar fibrin deposition between the cohorts. Fibrinoid vessel wall necrosis, haemorrhage and capillaritis were not features of COVID-19-related DAD.

conclusionsDAD is the primary histological manifestation of severe lung disease in COVID-19 patients who die both in hospital and in the community, suggesting no contribution of hyperoxaemic mechanical ventilation to the histological changes. There are no distinctive morphological features with which to confidently differentiate COVID-19-related DAD from DAD due to other causes.

Indexed as

AdultAgedAlveolar Epithelial CellsAutopsyBetacoronavirusCohort StudiesCoronavirus InfectionsCOVID-19FemaleHumansLungMaleMiddle AgedPandemicsPneumonia, ViralSARS-CoV-2autopsyCOVIDdiffuse alveolar damage

Identifiers

PMID32542743
PMCPMC7323403
OpenAlexW3034306775

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.