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Volume 26, Number 9—September 2020
Synopsis

Pathology and Pathogenesis of SARS-CoV-2 Associated with Fatal Coronavirus Disease, United States

Roosecelis B. Martines1Comments to Author , Jana M. Ritter1, Eduard Matkovic, Joy Gary, Brigid C. Bollweg, Hannah Bullock, Cynthia S. Goldsmith, Luciana Silva-Flannery, Josilene N. Seixas, Sarah Reagan-Steiner, Timothy Uyeki, Amy Denison, Julu Bhatnagar, Wun-Ju Shieh, Sherif R. Zaki, and COVID-19 Pathology Working Group
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (R.B. Martines, J.M. Ritter, E. Matkovic, J. Gary, B.C. Bollweg, C.S. Goldsmith, L. Silva-Flannery, J.N. Seixas, S. Reagan-Steiner, T. Uyeki, A. Denison, J. Bhatnagar, W.-J. Shieh, S.R. Zaki); Synergy America Inc., Atlanta (H. Bullock).

Main Article

Figure 4

Ultrastructural features of severe acute respiratory syndrome coronavirus 2 lung infection in fatal coronavirus disease. A) Top: alveolar space containing extracellular virions (arrows) with prominent surface projections. Bottom: cluster of virions in the alveolar space. Scale bars indicate 200 nm. B) Extracellular virions (arrow) associated with ciliated cells of the upper airway. Scale bar indicates 200 nm. C) Membrane-bound vacuoles (arrows) containing viral particles within the cytoplasm of

Figure 4. Ultrastructural features of severe acute respiratory syndrome coronavirus 2 lung infection in fatal coronavirus disease. A) Top: alveolar space containing extracellular virions (arrows) with prominent surface projections. Bottom: cluster of virions in the alveolar space. Scale bars indicate 200 nm. B) Extracellular virions (arrow) associated with ciliated cells of the upper airway. Scale bar indicates 200 nm. C) Membrane-bound vacuoles (arrows) containing viral particles within the cytoplasm of an infected type II pneumocyte; surfactant (lamellated material) indicted by arrowheads. Scale bar indicates 1 μm. D) Membrane-bound vacuole (double-headed arrow in panel C) containing virus particles (arrows) with the characteristic black dots that are cross-sections through the viral nucleocapsid. Arrowheads indicate vacuolar membrane. Scale bar indicates 200 nm. E) Viral particles (arrow) within a phagosome of an alveolar macrophage. Scale bar: 200 nm. F) Viral particles within a portion of a hyaline membrane. Scale bar indicates 800 nm. Inset: Higher magnification of virus particles indicated by arrow; scale bar indicates 200 nm.

Main Article

1These authors contributed equally to this article.

2Members of the COVID-19 Pathology Working Group: Rhonda Cole, Amanda Lewis, Pamela Fair, Lindsey Estetter.

Page created: May 21, 2020
Page updated: August 18, 2020
Page reviewed: August 18, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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