ArticleVirchows Archiv : an international journal of pathology2021
Increased number of pulmonary megakaryocytes in COVID-19 patients with diffuse alveolar damage: an autopsy study with clinical correlation and review of the literature.
Article in Virchows Archiv : an international journal of pathology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 4 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- An ancient examination in the face of a modern pandemic: systematic review of major clinicopathological autopsy findings.Revista da Associacao Medica Brasileira (1992) · 2022Pooled it
- Postmortem findings in COVID-19 fatalities: A systematic review of current evidence.Legal medicine (Tokyo, Japan) · 2022Pooled it
- Are platelet volume indices of clinical use in COVID-19? A systematic review.Frontiers in cardiovascular medicine · 2022Pooled it
- Invasive mould disease in fatal COVID-19: a systematic review of autopsies.The Lancet. Microbe · 2021Pooled it
- Studying the clinical, radiological, histological, microbiological, and immunological evolution during the different COVID-19 disease stages using minimal invasive autopsy.Scientific reports · 2022Trial
- Review
- Cause of Death Analysis in a 9½-Year-Old with COVID-19 and Dravet Syndrome.Pathophysiology : the official journal of the International Society for Pathophysiology · 2025Article
- Research progress of megakaryocytes and platelets in lung injury.Annals of medicine · 2024Review
- Article
- Megakaryocyte-induced contraction of plasma clots: cellular mechanisms and structural mechanobiology.Blood · 2024Article
- Postmortem Minimally Invasive Autopsy in Critically Ill COVID-19 Patients at the Bedside: A Proof-of-Concept Study at the ICU.Diagnostics (Basel, Switzerland) · 2024Article
- Alterations in the megakaryocyte transcriptome impacts platelet function in sepsis and COVID-19 infection.Thrombosis research · 2023Article
- Circulating SARS-CoV-2+ megakaryocytes are associated with severe viral infection in COVID-19.Blood advances · 2023Article
- Highly efficient platelet generation in lung vasculature reproduced by microfluidics.Nature communications · 2023Article
- Cardio-Pulmonary Histopathology with Clinical Correlations of Deceased Patients with COVID-19: A Case Series in Tehran, Iran.Archives of Iranian medicine · 2023Article
- Biogenesis aberration: One of the mechanisms of thrombocytopenia in COVID-19.Frontiers in physiology · 2023Article
- Cardiac megakaryocytes in SARS-CoV-2-positive autopsies.Histopathology · 2022Article
- Hematopoietic and Lung Platelet Biogenesis as a Prognostic Indicator in Idiopathic Pulmonary Fibrosis.American journal of respiratory and critical care medicine · 2022Article
- Don't you forget about me(gakaryocytes).Blood · 2022Article
- The pathological maelstrom of COVID-19 and cardiovascular disease.Nature cardiovascular research · 2022Review
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pulmonary megakaryocytes participate in the pathogenesis of lung damage, particularly in acute lung injury. Although megakaryocytes are not mentioned as a characteristic histologic finding associated to pulmonary injury, a few studies reveal that their number is increased in diffuse alveolar damage (DAD). In this autopsy study, we have observed a relevant number of pulmonary megakaryocytes in COVID-19 patients dying with acute lung injury (7.61 ± 5.59 megakaryocytes per 25 high-power fields vs. 1.14 ± 0.86 for the control group, p < 0.05). We analyzed samples of 18 patients, most of whom died after prolonged disease and use of mechanical ventilation. Most patients showed advanced DAD and abnormal coagulation parameters with high levels of fibrinogen, D-dimers, and variable thrombocytopenia. For comparison, pulmonary samples from a group of 14 non-COVID-19 patients dying with DAD were reviewed. They showed similar pulmonary histopathologic findings and an increase in the number of megakaryocytes (4 ± 4.17 vs. 1.14 ± 0.86 for the control group, p < 0.05). Megakaryocyte count in the COVID-19 group was greater but did not reach statistical significance (7.61 ± 5.59 vs. 4 ± 4.17, p = 0.063). Regardless of the cause, pulmonary megakaryocytes are increased in patients with DAD. Their high number seen in COVID-19 patients suggests a relation with the thrombotic events so often seen these patients. Since the lung is considered an active site of megakaryopoiesis, a prothrombotic status leading to platelet activation, aggregation and consumption may trigger a compensatory pulmonary response.
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