Inflammatory Profiles of Tracheal Biopsies From SARS-CoV-2 Patients

Giacomo Fiacchini; Agnese Proietti; Anello Marcello Poma; Miriana Picariello; Iacopo Dallan; Fabio Guarracino; Francesco Forfori; Gabriella Fontanini; Luca Bruschini

doi:10.3389/fmicb.2022.851460

Frontiers in Microbiology (Mar 2022)

Inflammatory Profiles of Tracheal Biopsies From SARS-CoV-2 Patients

Giacomo Fiacchini,
Agnese Proietti,
Anello Marcello Poma,
Miriana Picariello,
Iacopo Dallan,
Fabio Guarracino,
Francesco Forfori,
Gabriella Fontanini,
Luca Bruschini

Affiliations

Giacomo Fiacchini: Otolaryngology, Audiology and Phoniatric Operative Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
Agnese Proietti: Unit of Pathological Anatomy, University Hospital of Pisa, Pisa, Italy
Anello Marcello Poma: Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
Miriana Picariello: Otolaryngology, Audiology and Phoniatric Operative Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
Iacopo Dallan: Otolaryngology, Audiology and Phoniatric Operative Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
Fabio Guarracino: Cardiothoracic and Vascular Anaesthesia and Intensive Care, Department of Anaesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana (AOUP), Pisa, Italy
Francesco Forfori: Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
Gabriella Fontanini: Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
Luca Bruschini: Otolaryngology, Audiology and Phoniatric Operative Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy

DOI: https://doi.org/10.3389/fmicb.2022.851460
Journal volume & issue: Vol. 13

Abstract

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PurposeAn increasing number of laryngotracheal complications in mechanically ventilated COVID-19 patients has been reported in the last few months. Many etiopathogenetic hypotheses were proposed but no clear explanation of these complications was identified. In this paper we evaluated the possibility that the tracheal mucosa could be a high viral replication site that could weaken the epithelium itself.MethodsSubjects for the COVID-19 group and the control group were selected retrospectively according to specific criteria. Patients’ basic and clinical data were recorded and analyzed. Tracheal samples of both groups were collected during surgical tracheostomies and then analyzed from a histological and genetic-transcriptional point of view.ResultsFour COVID-19 patients were enrolled in this study and compared with four non-COVID-19 patients. No laryngotracheal complications were identified in both groups. The SARS-CoV-2 was detected in one out of four COVID-19 samples. A subepithelial inflammatory lymphomonocyte infiltrate was observed in all patients but two cases of the COVID-19 group showed vasculitis of small subepithelial vessels associated with foci of coagulative necrosis. Two gene sets (HALLMARK_INFLAMMATORY_RESPONSE and HALLMARK_ESTROGEN_RESPONSE_LATE) were significantly deregulated in COVID-19 patients compared to the control group.ConclusionThe altered inflammatory response of the COVID-19 patients could be another possible explanation of the increasing number of laryngotracheal complications.

Published in Frontiers in Microbiology

ISSN: 1664-302X (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Science: Microbiology
Website: http://www.frontiersin.org/journals/microbiology

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