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Copyright ©The Author(s) 2021.
World J Gastroenterol. Sep 21, 2021; 27(35): 5919-5931
Published online Sep 21, 2021. doi: 10.3748/wjg.v27.i35.5919
Table 4 Summary of the main studies reporting coronavirus disease 2019 related spleen dysfunction
Ref.
Country
Patients
Patients with spleen involvement, n (%)
Main findings
Feng et al[54]China66 (100)ACE2 expression on tissue-resident CD169+ macrophages in spleen; viral NP antigen found in ACE2+ cells in spleen; direct damage of spleen tissue (lymph follicle depletion, splenic nodule atrophy, lymphocyte reduction, etc.)
Remmelink et al[55]Belgium1711 (65)SARS-CoV-2 RNA detected in spleen autopsy samples by RT-PCR assay
Sekulic et al[56]United States22 (100)SARS-CoV-2 RNA detected at high level in spleen FFPE samples by RT-PCR assay
Han et al[58]China7356NAExpression of ACE2 in spleen tissue (lower than in other tissues), without difference according to sex
Li et al[59]China31NAExpression of ACE2 in spleen tissue (lower than in other tissues), without difference according to sex and age
Xu et al[60]China1010 (100)Decrease in spleen cell composition with decrease in lymphocyte components, white pulp atrophied, lymphoid follicles decreased or absent, increase in red pulp to white pulp ratio
Menter et al[61]Switzerland216 (29)Acute splenitis and/or septic neutrophilic leucocytosis of the red pulp, suggesting vascular disfunction in patients with COVID-19
Lax et al[62]Austria1110 (90)White pulp atrophy due to lymphocyte depletion, areas of haemorrhage with acute or chronic congestion
Duarte-Neto et al[63]Brazil55 (100)Lymphoid hypoplasia in 100%, red pulp haemorrhages in 60%, splenitis in 40%, extramedullary haematopoiesis in 50%, endothelial changes in 80%, vasculitis and arterial thrombus in 20%
Lenti et al[29]Italy6355 (87.3)IgM memory B cell depletion that correlates with increased mortality and superimposed infections
Kaneko et al[65]United States1111 (100)Loss of spleen germinal centres due to depletion of Bcl-6+ germinal centre B cells and Bcl-6+ germinal centre T follicular helper cells, resulting in a dysregulated humoral immune response