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Viropathic multinuclear syncytial giant cells in bronchial fluid from a patient with COVID-19
  1. Sylvia Stadlmann1,
  2. Robert Hein-Kuhnt2,
  3. Gad Singer1
  1. 1 Institute of Pathology, Kantonsspital Baden, Baden, Switzerland
  2. 2 Institute of Radiology, Kantonsspital Baden, Baden, Switzerland
  1. Correspondence to Professor Gad Singer, Institute of Pathology, Kantonsspital Baden, Baden 5404, Switzerland; gad.singer{at}

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Novel coronavirus (COVID-19) pneumonia has emerged as major global health threat as it continues to spread with increasing number of deaths. COVID-19 is an enveloped, single-stranded RNA coronavirus that is largely transmitted by inhalation of respiratory droplets. Most patients with COVID-19 have mild disease, but approximately 20% develop severe disease with subsequent respiratory symptoms.1 Early detection of lung involvement by COVID-19 in bronchial fluid may be important for timely therapeutic management. To date, the description of morphological changes in COVID-19 pneumonia is largely based on findings in a small number of autopsies.1 2

We present a case of a man in his 70s who was transferred to our hospital on 26 March 2020 with a hyperglycaemic crisis and increasing shortness of breath. He was known to have high blood pressure and type 2 diabetes that had been treated with linagliptin. The patient had a history of rectal cancer in 2016, which had been successfully treated by surgery, followed by chemotherapy for 1 month.

At admission, the patient was dehydrated and his blood glucose level was 30 mmol/L (normal range 3.9–5.8 mmol/L). His body temperature was normal. Within a few hours, his oxygen saturation level dropped from 93% to 50% and he …

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  • Handling editor Runjan Chetty.

  • Contributors All authors have contributed substantially to the manuscript justifying their authorship.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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