Covid-19’a Histopatolojik Bir Bakış: Akciğer, Böbrek, Beyin, Karaciğer

2002 ve 2012 yıllarında önceki koronavavirüs salgınları olan Şiddetli akut solunum sendromu koronavirüs (SARS‐ CoV) ve Ortadoğu solunum sendromu koronavirüs (MERS ‐ CoV) ortaya çıkmıştı. Sonrasında Aralık 2019'da Çin'in Hubei eyaleti Wuhan Şehrinde SARS‐CoV‐2 adında bir başka yüksek derecede patojenik koronavirüs ortaya çıktı ve hızla tüm dünyaya yayıldı. 11 Mart 2020 tarihinde hastalık pandemi, yani küresel salgın hastalık olarak ilan edilmiştir. Dünya Sağlık Örgütü (DSÖ) tarafından COVID-19 olarak adlandırılan bu virüs, inhalasyon veya enfekte damlacık yoluyla bulaşır ve kuluçka süresi 2 ila 14 gün arasında değişmektedir. Virüs, halsizlik, kuru öksürük, ateş, bulantı, kusma, koku kaybı, baş ağrısı ve en önemlisi solunum sıkıntısına neden olmaktadır. Birçok insan asemptomatiktir. Hastalık çoğu insanda hafif seyreder; bazılarında (genellikle yaşlılar ve kronik hastalığı olanlarda) pnömoniye, akut solunum sıkıntısı sendromuna (ARDS) ve çoklu organ fonksiyon bozukluğuna ilerleyebilir. Vaka ölüm oranının % 2 ile % 3 arasında olduğu tahmin edilmektedir. SARS-CoV-2, konakçı hücreleri anjiyotensin dönüştürücü enzim 2 (ACE2) reseptörleri yoluyla enfekte eder. Artan kanıtlar, koronavirüslerin her zaman solunum yollarıyla sınırlı olmadığını, ACE2 reseptörlerinin bulunduğu pek çok organı istila edebileceklerini göstermektedir. Dünya genelinde ilk vakanın çıktığı Aralık 2019’dan bu yana 8 aylık süre içerisinde vaka sayısı 14 milyonu, ölü sayısı 619 bini geçmiştir. Türkiye’de ise COVID-19 pozitif vaka sayısı 225 bine yaklaşmış olup maalesef aramızdan ayrılan insan sayısı 5500'ü geçmiştir. Bu derlemede COVID-19 nedeniyle hayatını kaybetmiş insanlara ait farklı organlardan alınan biyopsi örneklerinin histopatolojik bulguları bildirilmektedir.

Anahtar Kelimeler:

COVID-19, ACE2 reseptörü, Histopatoloji, Akciğer, Böbrek, Beyin, Karaciğer

A Histopathological Overview of Covid-19: Lung, Kidney, Brain, Liver

In 2002 and 2012, severe acute respiratory syndrome coronavirus (SARS‐CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), which were previous outbreaks of corovavirus, appeared. Then, in December 2019, another highly pathogenic coronavirus named SARS-CoV-2 appeared in Wuhan City, Hubei province of China, and it spread rapidly all over the world. On March 11, 2020, the disease was declared as a pandemic, a global epidemic. Called COVID-19 by the World Health Organization (WHO), this virus is transmitted through inhalation or infected droplets and the incubation period ranges from 2 to 14 days. This virus causes dry cough, fever, nausea, vomiting, loss of smell, headache and most importantly respiratory distress. Many people are asymptomatic. The disease is mild in most people; in some (usually the elderly and those with chronic disease) it can progress to pneumonia, acute respiratory distress syndrome (ARDS) and multi-organ dysfunction. The case death rate is estimated to be between 2% and 3%. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells through ACE2 receptors. Increasing evidence suggests that coronaviruses are not always limited to the airways, but can invade many organs with angiotensin converting enzyme 2 (ACE2) receptors. The number of cases has exceeded 14 million and the number of deaths exceeded 619 thousand in the 8-month period since December 2019, when the first case occurred worldwide. In Turkey, the number of COVID-19 positive cases has approached 225 thousand and unfortunately the number of people who died has exceeded 5500. In this review, histopathological findings of biopsy samples taken from different organs of people who died due to COVID-19 are reported.

Keywords:

COVID-19, ACE2 reseptörü, histopatoloji, akciğer, böbrek, beyin, karaciğer,

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