IR Sant Pau researchers map cellular damage in severe COVID-19 lungs

Researchers at the IR Sant Pau Research Institute in Barcelona have developed a spatial map to track the cellular and molecular mechanisms driving lung damage and fibrosis in severe COVID-19 cases. The study, published in Nature Communications, utilized spatial transcriptomics to analyze 91,068 microscopic regions of lung tissue from 19 deceased patients.

The analysis revealed a profound transformation in tissue organization as the disease progresses from normal lung function to acute diffuse alveolar damage (DAD) and eventually proliferative DAD. Key findings include a progressive loss of essential cells required for gas exchange and vascular function, alongside a significant expansion of peribronchial fibroblasts and altered immune responses.

Led by Dr. Manel Esteller, the study identified changes in the distribution and signaling of 45 different cell types. Specifically, researchers noted a decrease in alveolar type 1 (AT1) pneumocytes and an increase in type 2 (AT2) pneumocytes during the proliferative stage, reflecting the body's attempt to repair damage through progenitor cells.