Aplastic anemia patients with severe COVID-19 showed abnormal ultrastructure features on type II pneumocytes of lungs

Abstract

Type-II-pneumocytes from the bronchoalveolar fluids of aplastic anemia (AA) patients with COVID-19-induced acute respiratory distress syndrome (ARDS) were imaged to assess the ultrastructural alteration, especially in the number and size of the lamellar bodies. The mild (non-ARDS), and severe ARDS without comorbidities were used as reference for comparative ultrastructural analysis. The electron microscopic imaging of mild non-ARDS patients showed normal ultrastructure with surfactant-containing lamellar bodies of size range 0.5-1.00 μM with an area ranging from 0.3-0.8 μM2. The ARDS patients with diabetes and without any comorbidities showed larger lamellar bodies of the size range 0.8-1.4 μM with an area range from 0.5-1.50 μM2. However, AA patients revealed normal and giant lamellar bodies. These giant lamellar bodies showed a size range of 2.0-4.0 μM with an area ranging from 3.0- 5.0 μM2 with a lesser number/cell. This study reports the abnormal ultrastructural alteration of type II pneumocytes in AA patients with COVID-19.