How do the lungs of patients with COVID-19 differ from the lungs of patients with influenza?

Lungs, Organ, Anatomy, Bronchia, Bronchial Tubes

Bottom Line:

Autopsy findings of lungs from patients with COVID-19 show distinctive changes to their blood vessels compared to patients with influenza, suggesting that COVID-19 may cause a different disease process.


Ackermann, M. et al. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in COVID-19. New England Journal of Medicine (2020).

Date Published:

21 May 2020


Most patients die from COVID-19 due to acute respiratory distress system (ARDS), a condition characterized by fluid build up in the lungs and respiratory failure. Other respiratory viruses like influenza (i.e. the seasonal flu) also kill patients mainly through ARDS. However, there has been growing evidence that COVID-19 can damage blood vessels in the body, which can also contribute to respiratory failure. To learn more about the mechanism of disease that leads to death in COVID-19, researchers obtained lungs from autopsies of patients who died from COVID-19, and compared them to lungs of patients who died from influenza. Microscopic examination of lungs of patients with COVID-19 showed findings consistent of ARDS. In addition, the lungs from patients with COVID-19 had distinctive features in the blood vessels, including more damage to the lining of blood vessels, more small blood clots, and a greater amount of small vessel growth. These findings suggest that the mechanism of disease in COVID-19 is different from other respiratory viruses, which may have implications for how the disease is treated.

Summary by: Louis Huynh