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Fig. 5 | Critical Care

Fig. 5

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

Fig. 5

Microscopic histology and electron microscopy showing SARS-CoV-2 in lungs and kidneys of patients who died from COVID 19. a In a 76-year-old man with hypertension who died from a cardiac arrest 10 days after the onset of COVID 19 symptoms (no admission in the ICU), positive immunohistochemistry staining for SARS-CoV-2 is present in lung epithelial cells (black arrows) and endothelial cells (red arrows). Immunostaining was performed using a house-made antibody (University of Sao Paulo, Institute of Biomedical Sciences), using a 1:50 dilution, and revealed with 3,3′-Diaminobenzidine staining system b Alveolar space containing extracellular SARS-CoV-2 (arrows) with prominent surface profections (bottom: cluster of virions) c Extracellular SARS-CoV-2 particles (arrows) present in the airway epithelial and cilia (triangles). d An activated glomerular endothelial cell containing a vesicle close to the luminal border with virus-like particles (arrow and insert), adjacent to an erythrocyte (RC). e Injured endothelial cell of a pulmonary capillary containing SARS-CoV-2 (arrowheads). Swelling of the nucleus and cytoplasm partially obstructs the capillary lumen. Permission was granted by Martines et al. (©Centers for Disease Control and Prevention [38]) to reuse this figure (b), Permission was granted by Zhu et al. (©Massachusetts Medical Society [2]) to reuse this figure (c), Permission was granted by Menter et al. (©Public License (Creative Commons) [35]) to reuse this figure (d) and Permission was granted by Ackermann et al. (©The New England Journal of Medicine [29]) to reuse this figure (e)

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