Pulmonary Artery Vasa Vasorum Damage in Severe COVID-19-Induced Pulmonary Fibrosis

Weijian Huang; Tara D Richards; David J Kaczorowski; Kentaro Noda; Tanner Bartholow; Pablo G Sanchez; Julie A Phillippi

doi:10.1016/j.atssr.2023.12.019

Pulmonary Artery Vasa Vasorum Damage in Severe COVID-19-Induced Pulmonary Fibrosis

Ann Thorac Surg Short Rep. 2024 Jan 26;2(3):443-447. doi: 10.1016/j.atssr.2023.12.019. eCollection 2024 Sep.

Authors

Weijian Huang¹, Tara D Richards¹, David J Kaczorowski^{1

2}, Kentaro Noda¹, Tanner Bartholow³, Pablo G Sanchez^{1

2}, Julie A Phillippi^{1

2

4}

Affiliations

¹ Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
² McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
³ Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
⁴ Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania.

Abstract

Background: COVID-19 patients exhibit higher incidence of thrombosis in arteries and veins, including those in lungs. Vasa vasorum, which support large blood vessels, have shown involvement in these pathologic processes.

Methods: To further explore the extent of microvascular damage caused by COVID-19 infection, we examined resected main, right, or left pulmonary artery specimens from patients undergoing bilateral lung transplantation for COVID-19- or non-COVID-19-induced pulmonary fibrosis compared with organ donors by histologic and immunohistologic analyses.

Results: Vasa vasorum density was found to be higher in specimens procured from patients with COVID-19 and associated with pulmonary artery hypertension compared with lung transplant donors. In addition, we found immunothrombosis within vasa vasorum in specimens from COVID-19 patients with more immune infiltration, including CD15⁺, CD44⁺, and CD68⁺ cells.

Conclusions: These findings reveal that COVID-19 affects the vasa vasorum of pulmonary arteries and suggest that infection may lead to large-vessel dysfunction and organ failure.