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A lung affected by deadly forms of COVID-19 not only loses essential cells for breathing but also undergoes profound changes in its internal organization and the way its cells communicate with each other. A study involving the Sant Pau Research Institute (IR Sant Pau), published in Nature Communications, has created a spatial map of this transformation and identified some of the molecular mechanisms that accompany the progression of lung damage and fibrosis.

The study was led by Dr. Manel Esteller, head of the Cancer Epigenetics group at IR Sant Pau, ICREA research professor and professor of genetics at the University of Barcelona (UB), and included researchers from different Spanish and European institutions.

The authors analyzed lung tissue from 19 patients who died from COVID-19, seven with acute diffuse alveolar damage (DAD) and 12 with proliferative DAD, along with control lung samples. DAD is a lung injury that appears in severe forms of acute respiratory distress syndrome and is one of the main changes observed in fatal cases of COVID-19.

In total, the researchers studied 91,068 microscopic regions of lung tissue and used the Human Lung Cell Atlas as a reference to identify and locate 45 cell types.

Unlike conventional transcriptomic analyses, which require breaking the tissue apart and cause its original organization to be lost, spatial transcriptomics preserves the position of each analyzed region and allows gene expression to be related to the architecture of the lung.

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