Acute lymphocytic interstitial pneumonitis - A potentially fatal complication in COVID-19

COLOMBO (News 1st); Sri Lankan researchers have uncovered that acute lymphocytic interstitial pneumonitis (ALIP) is a potentially fatal complication in COVID-19 infection at the initial stages of lung involvement.

This is was revealed to the media on Monday (23) by Dr. S D Channa Perera, a Consultant Judicial Medical Officer at the National Institute of Infectious Diseases, Infectious Disease Hospital (IDH),Sri Lanka.

Sri Lanka is one of few countries which has performed post mortem examinations in deaths due to SARS CoV2 virus (COVID-19) infection.

"At the office of the Judicial Medical Officer of National Institute of Infectious Diseases (NIID)/Infectious Disease Hospital (IDH) we have performed over 100 post mortem examinations of deceased persons who were confirmed positive for COVID-19," said Dr. Perera.

He said that researchers observed acute lymphocytic interstitial pneumonitis (ALIP) as a potentially fatal complication in COVID-19 infection at the initial stages of lung involvement.

"This phenomenon of early onset ALIP has not 

been reported in the literature of COVID-19 lung pathophysiology to date. This is a narrative of our histological findings," he added.

In a research document he noted that the attempt is to highlight the importance early onset ALIP as a pathological entity in COVID-19 lung involvement, which will enhance the clinicians to better understand the pathophysiology of this new illness and modify their treatment strategies.

According to Dr. Perera, a small percentage of patients could develop lower respiratory symptoms.

Those who are vulnerable to this condition are the elderly, debilitated people, immunocompromised persons, and are undergoing treatment 

following transplantation, etc, a report added.

The two types of cells that line the alveolar wall are 

Type I pneumocytes which are squamous cells and 

type II pneumocytes which are cuboidal cells.

Type II pneumocytes produce surfactant that keeps the surface tension of the alveoli and prevent them 

getting collapsed.

At the initial stage of lower respiratory tract infections, in histological sections we have observed ALIP and Diffuse Alveolar Damage, with hyaline membrane formation, he noted.

In his report he added "We postulate early onset ALIP as an important entity in the pathophysiology and highlight that early clinical identification and 

treatment of ALIP could be the turning point in 

reversing the lung injury by halting disease 

progression towards diffuse alveolar damage or 

secondary infections."