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Multiscale three-dimensional pathology findings of COVID-19 diseased lung using high-resolution cleared tissue microscopy

By Guang Li, Sharon E Fox, Brian Summa, Bihe Hu, Carola Wenk, Aibek Akmatbekov, Jack L Harbert, Richard S. Vander Heide, J. Quincy Brown

Posted 17 Apr 2020
bioRxiv DOI: 10.1101/2020.04.11.037473

The study of pulmonary samples from individuals who have died as a direct result of COVID-19 infection is vital to our understanding of the pathogenesis of this disease. Histopathologic studies of lung tissue from autopsy of patients with COVID-19 specific mortality are only just emerging. All existing reports have relied on traditional 2-dimensional slide-based histological methods for specimen preparation. However, emerging methods for high-resolution, massively multiscale imaging of tissue microstructure using fluorescence labeling and tissue clearing methods enable the acquisition of tissue histology in 3-dimensions, that could open new insights into the nature of SARS-Cov-2 infection and COVID-19 disease processes. In this article, we present the first 3-dimensional images of lung autopsy tissues taken from a COVID-19 patient, including 3D "virtual histology" of cubic-millimeter volumes of the diseased lung, providing unique insights into disease processes contributing to mortality that could inform frontline treatment decisions.

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