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Fig. 4 | Critical Care

Fig. 4

From: SARS-CoV-2 pneumonia—receptor binding and lung immunopathology: a narrative review

Fig. 4

Angiogenesis and neovascularization in patients with severe SARS-CoV-2 pneumonia a Electron microcopy showing microvascular corrosion casts from the alveolar plexus of a healthy lung b Electron microcopy showing microvascular corrosion casts from the alveolar plexus of a COVID-19 injured lung with substantial architectural distortion c Electron microscopy showing pillar localizations (arrowheads) associated with the intussusceptive angiogenesis d Postmortem pulmonary arteriogram performed in a patient who died from non-COVID ARDS, 26 days after a massive aspiration. The vascular bed is rarefied and tortuous, suggesting a distorted neovascularization (e and f) Chronological comparison of intussusceptive and sprouting angiogenesis in lungs from patients with Covid-19 (orange colour) and lungs from patients with influenza A(H1N1) (blue colour) plotted as a function of the duration of hospitalization. In COVID 19 patients, intussusceptive angiogenesis predominates over sprouting angiogenesis and markedly increases with time. Permission was granted by Ackermann et al. (©Massachusetts Medical Society [29]) to reuse this figure (ac, e, f), and Permission was granted by Tomashefski (©Elsevier [39]) to reuse this figure (d)

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