COVID-19, PANDEMIC INFLUENZA A(H1N1): CLINICAL AND PATHOLOGICAL COMPARISONS

Authors

  • H. I. Gradil Kharkiv National Medical University, 2Communal Non-commercial Enterprise of the Kharkiv Regional Council «Regional Children’s Infectious Clinical Hospital» https://orcid.org/0000-0001-5655-6188
  • H. I. Gubina-Vakulyk Kharkiv National Medical University, 2Communal Non-commercial Enterprise of the Kharkiv Regional Council «Regional Children’s Infectious Clinical Hospital» https://orcid.org/0000-0003-3816-8530
  • K. V. Yurko Kharkiv National Medical University, 2Communal Non-commercial Enterprise of the Kharkiv Regional Council «Regional Children’s Infectious Clinical Hospital» https://orcid.org/0000-0002-1226-5431
  • P. V. Nartov Kharkiv National Medical University, 2Communal Non-commercial Enterprise of the Kharkiv Regional Council «Regional Children’s Infectious Clinical Hospital»
  • O. P. Lukashova S. P. Grigoriev Institute of Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine» https://orcid.org/0000-0002-4518-5104
  • Yu. B. Khalusheva Municipal Non-commercial Enterprise of the Kharkiv Regional Council «Regional anti-tuberculosis Dispensary”

DOI:

https://doi.org/10.11603/1681-2727.2023.3.14197

Keywords:

COVID 19, influenza A(H1N1)pdm09, autopsy, patho-anatomical data, v, acute respiratory distress syndrome

Abstract

SUMMARY. The aim of the study. Study of the clinical course and pathomorphological data of influenza A(H1N1)pdm09 and SARS-CoV-2/COVID-19 in a comparative aspect.

Materials and methods. A retrospective study of two independent cohorts of patients who died after infec­tion with either COVID-19 (n=40) or influenza A(H1N1)pdm09 (n=32) and a microscopic study with additional consultation of microspecies of COVID-19 cases (n=12), pandemic flu (n=14). To study the morphological state of the lungs, microscopic examination of sections of lung tissue placed on glass slides, stained with hematoxylin and eosin, and semi-thin sections from blocks prepared for electron microscopic studies were used. Statistical methods are applied, including non-parametric ones (Chi-square, Fisher’s exact test).

The results. Manifestations of the clinical course of influenza A(H1N1)pdm09 (2009, 2010) and COVID-19 (2020, 2021, 2023 cases) were evaluated. Clinical data related to the day of illness during hospitalization, life expectancy, leading risk factors among deceased patients were compared. Pathohistological features of diffuse alveolar damage (DAP), the state of the endothelium of microvessels, hemorrhagic manifestations, formation of blood clots, pulmonary fibrosis were evaluated with an emphasis on the morphological state of the lungs. The results of the pathomorphological examination were analyzed, differences between influenza A(H1N1)pdm09 and COVID-19 were identified.

Conclusions. When comparing the pathohistological features of lungs in deceased patients with SARS-CoV-2/COVID-19 and influenza A(H1N1), differences in lung pathobiology were revealed. During primary morphogenesis in COVID-19, more significant damage to the endothelium is observed during viremia. This, in our opinion, is at the beginning of the formation of “hyaline” membranes, and interstitial pneumonia, and significant pneumofibrosis. Pathomorphological changes in the trachea and bronchi among deceased patients with a diagnosis of influenza were observed more often than in cases of COVID-19. With pandemic flu, people died at a younger age than with COVID-19.

Author Biographies

H. I. Gradil, Kharkiv National Medical University, 2Communal Non-commercial Enterprise of the Kharkiv Regional Council «Regional Children’s Infectious Clinical Hospital»

PhD of Medicine Sciences, Associate Professor of the Department of Infectious Diseases and Phthisiatry of the Kharkiv National Medical University

H. I. Gubina-Vakulyk, Kharkiv National Medical University, 2Communal Non-commercial Enterprise of the Kharkiv Regional Council «Regional Children’s Infectious Clinical Hospital»

MD, Professor of the Department of Pathological Anatomy of the Kharkiv National Medical University

K. V. Yurko, Kharkiv National Medical University, 2Communal Non-commercial Enterprise of the Kharkiv Regional Council «Regional Children’s Infectious Clinical Hospital»

MD, professor, Head of the Department of Infectious Diseases and Phthisiology of the Kharkiv National Medical University

P. V. Nartov, Kharkiv National Medical University, 2Communal Non-commercial Enterprise of the Kharkiv Regional Council «Regional Children’s Infectious Clinical Hospital»

MD, Professor, acting Head of the Department of Infectious Diseases, Children’s Infectious Diseases, Phthisiology and Pulmonology of the Educational and Scientific Institute of Postgraduate Education of the Kharkiv National Medical University

O. P. Lukashova, S. P. Grigoriev Institute of Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine»

PhD (Biological Sciences), leading researcher of the Laboratory of Radiation Oncology of the State Institution «Institute of Medical Radiology and Oncology named after S.P. Grigoriev of the National Academy of Medical Sciences of Ukraine»

Yu. B. Khalusheva, Municipal Non-commercial Enterprise of the Kharkiv Regional Council «Regional anti-tuberculosis Dispensary”

pathologist of the highest category, Municipal Non-commercial Enterprise of the Kharkiv Regional Council «Regional anti-tuberculosis Dispensary

References

Boehm, A. B., Wolfe, M. K., White, B. J., Hughes, B., Duong, D., & Bidwell, A. (2023). More than a Tripledemic: Influenza A Virus, Respiratory Syncytial Virus, SARS-CoV-2, and Human Metapneumovirus in Wastewater during Winter 2022-2023. Environmental science & technology letters, 10 (8), 622–627. https://doi.org/10.1021/acs.estlett.3c00385 DOI: https://doi.org/10.1021/acs.estlett.3c00385

Furlow B. (2023) Triple-Demic Overwhelms Pediatric Units in US Hospitals. Lancet Child & Adolescent Health 7 (2), https://doi.org/10.1016/S2352-4642(22)00372-8. DOI: https://doi.org/10.1016/S2352-4642(22)00372-8

Mboumba Bouassa, R. S., Tonen-Wolyec, S., Veyer, D., Péré, H., & Bélec, L. (2022). Analytical performances of the AMPLIQUICK® Respiratory Triplex assay for simultaneous detection and differentiation of SARS-CoV-2, influenza A/B and respiratory syncytial viruses in respiratory specimens. PloS One, 17(1), e0262258. https://doi.org/10.1371/journal.pone.0262258 DOI: https://doi.org/10.1371/journal.pone.0262258

Luo, J., Zhang, Z., Zhao, S., & Gao, R. (2023). A Comparison of Etiology, Pathogenesis, Vaccinal and Antiviral Drug Development between Influenza and COVID-19. International journal of molecular sciences, 24(7), 6369. https://doi.org/10.3390/ijms24076369 DOI: https://doi.org/10.3390/ijms24076369

Choreño-Parra JA, Jiménez-Álvarez LA, Cruz-Lagunas A, et al. Clinical and Immunological Factors That Distinguish COVID-19 From Pandemic Influenza A(H1N1). Front Immunol. 2021;12:593595. Published 2021 Apr 21. doi:10.3389/fimmu.2021.593595 DOI: https://doi.org/10.3389/fimmu.2021.593595

Sagnelli, C., Celia, B., Monari, C., Cirillo, S., De Angelis, G., Bianco, A., & Coppola, N. (2021). Management of SARS-CoV-2 pneumonia. Journal of Medical Virology, 93(3), 1276–1287. https://doi.org/10.1002/jmv.26470 DOI: https://doi.org/10.1002/jmv.26470

Azevedo, M. L. V., Zanchettin, A. C., Vaz de Paula, C. B., Motta Júnior, J. D. S., Malaquias, M. A. S., Raboni, S. M., Neto, P. C., Zeni, R. C., Prokopenko, A., Borges, N. H., Godoy, T. M., Benevides, A. P. K., de Souza, D. G., Baena, C. P., Machado-Souza, C., & de Noronha, L. (2021). Lung Neutrophilic Recruitment and IL-8/IL-17A Tissue Expression in COVID-19. Frontiers in Immunology, 12, 656350. https://doi.org/10.3389/fimmu.2021.656350 DOI: https://doi.org/10.3389/fimmu.2021.656350

Riabokon O. V., Furyk O. O., Riabokon Yu. Yu., Kalashnyk K. V. (2023). Mixed infection of COVID-19 and influenza: current state of the issue. Infectious Diseases 1(111) 2023, 4-11. DOI 10.11603/1681-2727.2023.1.13919 [in Ukrainian]

Rodrigo da Rosa Mesquita, Luiz Carlos Francelino Silva Junior, Fernanda Mayara Santos Santana, Tatiana Farias de Oliveira, Rafaela Campos Alcântara, Gabriel Monteiro Arnozo, Etvaldo Rodrigues da Silva Filho, Aisla Graciele Galdino dos Santos, Euclides José Oliveira da Cunha, Saulo Henrique Salgueiro de Aquino, and Carlos Dornels Freire de Souza. (2020). Clinical manifestations of COVID-19 in the general population: systematic review Wien Klin Wochenschr. 2021;133(7-8): 377–382. Published online 2020 Nov 26. DOI: 10.1007/s00508-020-01760-4 PMCID: PMC7689634 PMID: 33242148 DOI: https://doi.org/10.1007/s00508-020-01760-4

Jiang, C., Yao, X., Zhao, Y., Wu, J., Huang, P., Pan, C., Liu, S., & Pan, C. (2020). Comparative review of respiratory diseases caused by coronaviruses and influenza A viruses during epidemic season. Microbes and Infection, 22 (6-7), 236–244. https://doi.org/10.1016/j.micinf.2020.05.005. DOI: https://doi.org/10.1016/j.micinf.2020.05.005

Mohamed Khosroshahi, L., Rokni, M., Mokhtari, T., & Noorbakhsh, F. (2021). Immunology, immunopathogenesis and immunotherapeutics of COVID-19; an overview. International Immunopharmacology, 93, 107364.https://doi.org/10.1016/j.intimp.2020.107364 DOI: https://doi.org/10.1016/j.intimp.2020.107364

Jansen, A. J. G., Spaan, T., Low, H. Z., Di Iorio, D., van den Brand, J., Tieke, M., Barendrecht, A., Rohn, K., van Amerongen, G., Stittelaar, K., Baumgärtner, W., Osterhaus, A., Kuiken, T., Boons, G. J., Huskens, J., Boes, M., Maas, C., & van der Vries, E. (2020). Influenza-induced thrombocytopenia is dependent on the subtype and sialoglycan receptor and increases with virus pathogenicity. Blood Advances, 4 (13), 2967–2978. https://doi.org/10.1182/bloodadvances.2020001640 DOI: https://doi.org/10.1182/bloodadvances.2020001640

Kamp, J. C., Neubert, L., Ackermann, M., Stark, H., Werlein, C., Fuge, J., Haverich, A., Tzankov, A., Steinestel, K., Friemann, J., Boor, P., Junker, K., Hoeper, M.M., Welte, T., Laenger, F., Kuehnel, M. P., & Jonigk, D. D. (2022). Time-Dependent Molecular Motifs of Pulmonary Fibrogenesis in COVID-19. International Journal of Molecular Sciences, 23(3), 1583. https://doi.org/10.3390/ijms23031583. DOI: https://doi.org/10.3390/ijms23031583

Ackermann, M., Verleden, S. E., Kuehnel, M., Haverich, A., Welte, T., Laenger, F., Vanstapel, A., Werlein, C., Stark, H., Tzankov, A., Li, W. W., Li, V. W., Mentzer, S. J., & Jonigk, D. (2020). Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in COVID-19. The New England Journal of Medicine, 383(2), 120–128. https://doi.org/10.1056/NEJMoa2015432 DOI: https://doi.org/10.1056/NEJMoa2015432

Meyer, N. J., Gattinoni, L., & Calfee, C. S. (2021). Acute respiratory distress syndrome. Lancet (London, England), 398(10300), 622–637. https://doi.org/10.1016/S0140-6736(21)00439-6 DOI: https://doi.org/10.1016/S0140-6736(21)00439-6

Ramadori, G. P. (2022). SARS-CoV-2-Infection (COVID-19): Clinical Course, Viral Acute Respiratory Distress Syndrome (ARDS) and Cause(s) of Death. Medical Sciences (Basel, Switzerland), 10(4), 58. https://doi.org/10.3390/medsci10040058 DOI: https://doi.org/10.3390/medsci10040058

Elsoukkary, S. S., Mostyka, M., Dillard, A., Berman, D. R., Ma, L. X., Chadburn, A., Yantiss, R. K., Jessurun, J., Seshan, S. V., Borczuk, A. C., & Salvatore, S. P. (2021). Autopsy Findings in 32 Patients with COVID-19: A Single-Institution Experience. Pathobiology: Journal of Immunopathology, Molecular and Cellular Biology, 88(1), 56–68. https://doi.org/10.1159/000511325 DOI: https://doi.org/10.1159/000511325

The ARDS Definition Task Force. Acute respiratory distress syndrome: the Berlin Definition //JAMA. June 20 2012; Vol 307 No. 23: 2526–2533. DOI: 10. 1001/jama.2012.5669. DOI: https://doi.org/10.1001/jama.2012.5669

Harris, J. R., Richwood, D., Hames, B. D. Electron microscopy in biology. in the practical approach series. New York, US: Oxford University Press.1991;308.

Gradil, G. I. (2016) Clinical analysis of fatalities from influenza, including a (H1N1) pdm09, in the pandemic and post-pandemic periods (2009-2016). ScienceRise 3 (3 (20), 57-64. DOI:10.15 587/2313-846.65103 DOI: https://doi.org/10.15587/2313-8416.2016.65103

Gubina-Vakulik, G., Gradil, G. (2023) Elements of COVID-19 morphogenesis after the development of viremia in the analysis of sectional cases of early death. 35rd European Congress of Pathology – Abstracts Virchows Archiv European Journal of Pathology (2023) 483 (Suppl 1):S1–S391, September 2023, S.148. DOI: https://doi.org/10.1007/s00428-023-03602-w

Gubina-Vakulik, G., Gradil, G. (2023). Elements of COVID-19 morphogenesis after the development of viremia in the analysis of sectional cases of early death G. Gubina-Vakulik, G. Gradil. KhNMU, Ukraine. 33rd European Congress of Pathology - Abstracts. Virchows Arch. Volume 483 Supplement 1 September 2023. European Journal of Pathology. E-Posters Autopsy Pathology E-PS-01-011

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Published

2023-10-16

How to Cite

Gradil, H. I., Gubina-Vakulyk, H. I., Yurko, K. V., Nartov, P. V., Lukashova, O. P., & Khalusheva, Y. B. (2023). COVID-19, PANDEMIC INFLUENZA A(H1N1): CLINICAL AND PATHOLOGICAL COMPARISONS. Infectious Diseases – Infektsiyni Khvoroby, (3), 15–27. https://doi.org/10.11603/1681-2727.2023.3.14197

Issue

No. 3 (2023)

Section

Original investigations

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Copyright (c) 2023 Г. І. Граділь; Г. І. Губіна-Вакулик, К. В. Юрко, П. В. Нартов, О. П. Лукашова, Ю. Б. Халушева

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