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Native Endogenous Fluorescence Imaging Detects Vascular Occlusions in Patients with COVID-19

16 Pages Posted: 17 May 2021

See all articles by Jeeshan Singh

Jeeshan Singh

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology

Irmgard Herrmann

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology

Jasmin Knopf

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology

Aparna Mahajan

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology

Christine Schauer

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology

Xiaomei Shan

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology

Arndt Hartmann

Friedrich-Alexander-Universität Erlangen-Nürnberg

Ralf J. Rieker

Friedrich-Alexander-Universität Erlangen-Nürnberg - Institut für Pathologie

Katja Evert

University of Regensburg - Institute of Pathology

Christina Falkeis

Klinikum Bayreuth - Institute of Pathology

Elisabeth Naschberger

Friedrich-Alexander-Universität Erlangen-Nürnberg - Division of Molecular and Experimental Surgery

Saskia von Stillfried

RWTH Aachen University - Institute of Pathology

Peter Boor

RWTH Aachen University - Division of Nephrology and Clinical Immunology

Luis E. Munoz

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology

Georg Schett

Friedrich-Alexander University (FAU) Erlangen-Nürnberg - Rheumatology and Immunology

Martin Herrmann

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology

More...

Abstract

Background: A number of histopathological reports showed the presence of widespread thrombosis and associated morphology in pulmonary vessels of patients with COVID-19. Later, we identified vascular occlusions with neutrophils and neutrophil extracellular traps (NETs), as major components, in autopsy tissue from patients with COVID-19.

Methods: We, here investigated 109 lung specimens from 17 patients with COVID-19 and compared them with 11 lung specimens from two patients who succumbed to pulmonary embolism and acute cardiac. Healthy lung specimens from four patients served as controls. We studied these autopsy lung specimens using immunohistochemistry and native endogenous fluorescence.

Findings: We present a label-free imaging technique using native endogenous fluorescence that enables the visualization of occluded vessels. We demonstrate that native endogenous fluorescence identified occluded vessels in tissue specimens from patients with COVID-19.

Interpretation: Label-free detection of occluded vessels enabled the detection of affected occluded vessels in lung specimens of patients with COVID-19 where the occluding components showed varying contents of neutrophil-derived materials.

Funding Statement: Deutsche Forschungsgemeinschaft (DFG), EU, Volkswagen-Stiftung

Declaration of Interests: All authors have no conflicts of interests to declare.

Ethics Approval Statement: An institutional approval from each local Ethical Committee was obtained (permit #193_13B; permit # 174_20B; EK 092/20; EK 119/20; EK 460/20).

Keywords: COVID-19, immunothrombosis, native endogenous fluorescence, pleomorphism, neutrophils

Suggested Citation

Singh, Jeeshan and Herrmann, Irmgard and Knopf, Jasmin and Mahajan, Aparna and Schauer, Christine and Shan, Xiaomei and Hartmann, Arndt and Rieker, Ralf J. and Evert, Katja and Falkeis, Christina and Naschberger, Elisabeth and von Stillfried, Saskia and Boor, Peter and Munoz, Luis E. and Schett, Georg and Herrmann, Martin, Native Endogenous Fluorescence Imaging Detects Vascular Occlusions in Patients with COVID-19. Available at SSRN: https://ssrn.com/abstract=3847751 or http://dx.doi.org/10.2139/ssrn.3847751

Jeeshan Singh

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology ( email )

Erlangen
Germany

Irmgard Herrmann

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology ( email )

Erlangen
Germany

Jasmin Knopf

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology ( email )

Erlangen
Germany

Aparna Mahajan

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology ( email )

Erlangen
Germany

Christine Schauer

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology ( email )

Erlangen
Germany

Xiaomei Shan

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology ( email )

Erlangen
Germany

Arndt Hartmann

Friedrich-Alexander-Universität Erlangen-Nürnberg

Lange Gasse 20
Lange Gasse 20,
Nürnberg, 90403
Germany

Ralf J. Rieker

Friedrich-Alexander-Universität Erlangen-Nürnberg - Institut für Pathologie ( email )

Lange Gasse 20
Lange Gasse 20,
Nürnberg, 90403
Germany

Katja Evert

University of Regensburg - Institute of Pathology ( email )

93040 Regensburg
D-93040 Regensburg, 93053
Germany

Christina Falkeis

Klinikum Bayreuth - Institute of Pathology ( email )

Preuschiwtzer Str. 101
Bayreuth, Bavaria 95445
Germany

Elisabeth Naschberger

Friedrich-Alexander-Universität Erlangen-Nürnberg - Division of Molecular and Experimental Surgery ( email )

Lange Gasse 20
Lange Gasse 20,
Nürnberg, 90403
Germany

Saskia Von Stillfried

RWTH Aachen University - Institute of Pathology ( email )

Templergraben 55
52056 Aachen, 52056
Germany

Peter Boor

RWTH Aachen University - Division of Nephrology and Clinical Immunology

Templergraben 55
52056 Aachen, 52056
Germany

Luis E. Munoz

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology ( email )

Erlangen
Germany

Georg Schett

Friedrich-Alexander University (FAU) Erlangen-Nürnberg - Rheumatology and Immunology

Fachbereich Rechtswissenschaft
Schillerstr. 1
Erlangen, DE 91054
Germany

Martin Herrmann (Contact Author)

Friedrich-Alexander-Universität Erlangen-Nürnberg - Department of Internal Medicine 3 - Rheumatology and Immunology ( email )

Erlangen
Germany