Residual SARS-CoV-2 Presence in the Respiratory Tract and Lung Parenchyma (After SARS-CoV-2 Infection or COVID-19)

Study Overview
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Brief Summary
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The aim of this study is to confirm or rule out the residual presence and viability of SARS- CoV-2 in the respiratory tract and lung parenchyma of patients previously infected with SARS-CoV-2. Presence and viability of SARS-CoV-2 in lung tissue will be assessed with reverse transcriptase-polymerase chain reaction (PCR) and viral culture. The histological location of residual SARS-CoV-2 will be determined with fluorescence immunohistochemistry and single molecule fluorescence in situ hybridization, targeting viral proteins and RNA respectively.

Detailed Description
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The investigators will collect residuary lung tissue after medically indicated pulmonary resections at the Thoracic Surgery Department of University Hospitals Leuven. More specifically the investigators will collect lung tissue from patients that had earlier PCR proven COVID-19 and/or serum anti-SARS-CoV-2 antibodies. Furthermore, for negative control of the methodology the investigators will also collect lung tissue from patients that have no signs for earlier SARS-CoV-2 infection.

Official Title
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Residual SARS-CoV-2 Presence in the Respiratory Tract and Lung Parenchyma

Conditions
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Covid19

Intervention / Treatment
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* Diagnostic Test: Lung biopsy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient requires medically indicated pulmonary resection Informed consent Exclusion Criteria: Active SARS-CoV-2 infection/COVID-19 No informed consent

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Subjects with earlier PCR-proven COVID-19 and/or serum anti-SARS-CoV-2 antibodies<br>Patients that require a medically indicated pulmonary resection. | Diagnostic Test: Lung biopsy<br>* Biopsy of residuary material from a medically indicated pulmonary resection<br>|
| Subjects WITHOUT earlier PCR-proven COVID-19 and/or serum anti-SARS-CoV-2 antibodies<br>Patients that require a medically indicated pulmonary resection. | Diagnostic Test: Lung biopsy<br>* Biopsy of residuary material from a medically indicated pulmonary resection<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reverse transcriptase-PCR | Detection of SARS-CoV-2 RNA in lung tissue homogenate with primers targeting both genomic and subgenomic RNA | Single time point. | 
| Fluorescence immunohistochemistry (IHC) | Determining the histological presence of SARS-CoV-2 viral proteins in lung tissue with commercially available antibodies against the SARS-CoV-2 spike and nucleocapsid proteins | Single time point. | 
| Single molecule fluorescence in situ hybridization (smFISH) | Determining the presence of SARS-COV-2 viral RNA in lung tissue with commercially available probes targeting both sense and anti-sense viral RNA | Single time point. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Viral culture | Determining viability of SARS-CoV-2 in case of a low revere transcriptase-PCR cycling threshold | Single time point. |