Histopathological Features of Emerging Infectious Diseases: Lessons from COVID-19, Mpox, and Lassa Fever
Keywords:
Histopathology, emerging infectious disease, COVID -19, SARS-CoV-2, mpox, Lassa feverAbstract
Abstract: Emerging infectious diseases (EIDs) constitute a persistent and escalating global health challenge. Understanding their histopathological signatures is critical for accurate diagnosis, elucidation of pathogenesis, and guidance of therapeutic strategies. This review examines and compares the histopathological features of three significant EIDs: coronavirus disease 2019 (COVID-19), mpox (formerly monkeypox), and Lassa fever. A narrative literature review was conducted using studies published between January 2000 and December 2024 in PubMed, Scopus, and Web of Science. Keywords were COVID - 19 histopathology, SARS -COV -2 autopsy, mpox pathology, monkeypox histopathology, Lassa fever pathology, and vascular hemorrhagic fever histology. Preference was given to autopsy reports and series of cases of biopsies. Diffuse alveolar damage, microvascular thrombosis, and pulmonary vascular endothelialitis characterize COVID-19. Epidermal ballooning degeneration, intracytoplasmic inclusion bodies, and vesiculopustular eruptions depict Mpox. Lassa fever is characterized by midzonal hepatocellular necrosis, lymphoid depletion, and a surprisingly low extent of inflammatory infiltrate. Each disease shows unique cytopathic effects, inflammatory patterns, and organ tropism that reflect distinct viral pathogenic mechanisms. The histopathological examination cannot be neglected in the study of EIDs. The comparison of the tissue results shows the divergent and convergent pathogenic mechanisms with vital diagnostic and therapeutic implications. The lessons learned during COVID-19, mpox, and Lassa fever outbreaks are cumulative and inform the strategies of readiness in the event of future pandemics.
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