Disorganized adrenocortical zonational structure in COVID-19 patients: Implications of critical illness duration
作者全名：Wen, Tian-Zi; Fu, Wen -Juan; Xiao, Shi-Qi; Wang, Shuai; Li, Tian-Ran; Chen, Xin-Yu; Chen, He -Yuan; Luo, Jie; Bian, Xiu-Wu; Yao, Xiao-Hong
作者地址：[Wen, Tian-Zi; Xiao, Shi-Qi; Wang, Shuai; Li, Tian-Ran; Chen, Xin-Yu; Chen, He -Yuan; Luo, Jie; Bian, Xiu-Wu; Yao, Xiao-Hong] Third Mil Med Univ, Southwest Hosp, Inst Pathol, Army Med Univ, Chongqing 400038, Peoples R China; Minist Educ China, Key Lab Tumor Immunopathol, Chongqing, Peoples R China
通信作者：Yao, XH (通讯作者)，Third Mil Med Univ, Southwest Hosp, Inst Pathol, Army Med Univ, Chongqing 400038, Peoples R China.
来源：PATHOLOGY RESEARCH AND PRACTICE
ESI学科分类：CLINICAL MEDICINE
WOS号：WOS:001208070000001
JCR分区：Q2
影响因子：2.9
年份：2024
卷号：256
期号：
开始页：
结束页：
文献类型：Article
关键词：COVID-19; Adrenal cortex; Structural disorganization; Areas of cortical zonations; Corticosteroid receptor
摘要：Aberrant adrenal function has been frequently reported in COVID-19 patients, but histopathological evidence remains limited. This retrospective autopsy study aims to scrutinize the impact of COVID-19 duration on adrenocortical zonational architecture and peripheral corticosteroid reactivity. The adrenal glands procured from 15 long intensive care unit (ICU)-stay COVID-19 patients, 9 short ICU-stay COVID-19 patients, and 20 matched controls. Subjects who had received glucocorticoid treatment prior to sampling were excluded. Applying hematoxylin and eosin (H&E) and immunohistochemical (IHC) staining, we disclosed that the adrenocortical zonational structure was substantially disorganized in COVID-19 patients, which long ICU-stay patients manifested a higher prevalence of severe disorganization (67%) than short ICU-stay patients (11%; P = 0.0058). The adrenal cortex of COVID-19 patients exhibited a 40% decrease in the zona glomerulosa (ZG) area and a 74% increase in the zona fasciculata (ZF) area (both P < 0.0001) relative to controls. Furthermore, among long ICU-stay COVID-19 patients, the ZG area diminished by 31% (P = 0.0004), and the ZF area expanded by 27% (P = 0.0004) in comparison to short ICU-stay patients. The zona reticularis (ZR) area remained unaltered. Nuclear translocation of corticosteroid receptors in the liver and kidney of long ICU-stay COVID-19 patients was at least 43% lower than in short ICU-stay patients (both P < 0.05). These findings underscore the necessity for clinicians to monitor adrenal function in long-stay COVID-19 patients.
基金机构：National Key Research and Devel-opment Program of China [2023YFC3041700]; R&D Program of Guangzhou Laboratory [SRPG22-006, SRPG23-001]
基金资助正文：This study was supported by the National Key Research and Devel-opment Program of China (Nos. 2023YFC3041700) , R&D Program of Guangzhou Laboratory (Grant No. SRPG23-001) and R&D Program of Guangzhou Laboratory (Grant No. SRPG22-006) .
