Autopsy and Case Reports (Jun 2024)

Thrombosis of the vasa vasorum of the large and medium size pulmonary artery and vein leads to pulmonary thromboembolism in COVID-19

  • Hubert Daisley,
  • Oneka Acco,
  • Martina Daisley,
  • Dennecia George,
  • Lilly Paul,
  • Errol James,
  • Arlene Rampersad,
  • Farhaana Narinesingh,
  • Ornella Humphrey,
  • Johann Daisley,
  • Melissa Nathan

DOI
https://doi.org/10.4322/acr.2024.491
Journal volume & issue
Vol. 14

Abstract

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The vasa vasorum of the large pulmonary vessels is involved in the pathology of COVID-19. This specialized microvasculature plays a major role in the biology and pathology of the pulmonary vessel walls. We have evidence that thrombosis of the vasa vasorum of the large and medium-sized pulmonary vessels during severe COVID-19 causes ischemia and subsequent death of the pulmonary vasculature endothelium. Subsequent release of thrombi from the vasa interna into the pulmonary circulation and pulmonary embolism generated at the ischemic pulmonary vascular endothelium site, are the central pathophysiological mechanisms in COVID-19 responsible for pulmonary thromboembolism. The thrombosis of the vasa vasorum of the large and medium-sized pulmonary vessels is an internal event leading to pulmonary thromboembolism in COVID-19.

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