https://www.washingtonpost.com/health/2020/07/01/coronavirus-autopsies-findings/?
Coronavirus autopsies: A story of 38 brains, 87 lungs and 42 hearts
July 1, 2020
Medical experts say autopsies are becoming a critical source of information on coronavirus as scientists race to understand it.
Autopsies have confirmed that the virus does attack the lungs with the most ferocity.
But the pathogen was also found in the kidneys, liver and the brain, where some damage could be permanent in survivors.
Dissecting 38 brains, 87 lungs and 42 hearts of people who died from covid-19 revealed surprising and alarming results.
Very interesting article...reads like a scary epidemic novel...
[...]
Rapkiewicz, who directs autopsies at NYU Langone Health, noticed that some organs had far too many of a special cell rarely found in those places. She had never seen that before, yet it seemed vaguely familiar. She raced to her history books and — in a eureka moment — found a reference to a 1960s report on a patient with dengue fever.
In dengue, a mosquito-borne tropical disease, she learned, the virus appeared to destroy these cells, which produce platelets, leading to uncontrolled bleeding. The novel coronavirus seemed to amplify their effect, causing dangerous clotting.
She was struck by the parallels: “
Covid-19 and dengue sound really different, but the cells that are involved are similar.”
[...]
Another unexpected finding, pathologists said, i
s that oxygen deprivation of the brain and the formation of blood clots may start early in the disease process. That could have major implications for how people with covid-19 are treated at home, even if they never need to be hospitalized.
[...]
One of the first American investigations to be made public, on April 10, was out of New Orleans. The patient was a 44-year-old man who had been treated at LSU Health. Richard Vander Heide remembers cutting the lung and
discovering what were probably hundreds or thousands of microclots.
“I will never forget the day,” recalled Vander Heide, who has been performing autopsies since 1994. “I said to the resident, ‘
This is very unusual.’ I had never seen something like this.”
But as he moved onto the next patient and the next, Vander Heide saw the same pattern. He was so alarmed, he said, that he shared the paper online before submitting it to a journal so the information could be used immediately by doctors.
[...]
The next organ studied up close was the heart.
One of the most frightening early reports about the coronavirus from China was that a significant percentage of hospitalized patients — up to 20 to 30 percent — appeared to have myocarditis that could lead to sudden death. The condition involves the thickening of the muscle of the heart so that it can no longer pump efficiently.
[...]
NYU Langone’s Rapkiewicz, who studied seven hearts, was struck by the abundance in the heart of rare cells called
megakaryocytes. The cells, which produce platelets that control clotting,
typically exist only in the bone marrow and lungs. When she went back to the lung samples from the coronavirus patients, she discovered those cells were too plentiful there, too.
“I could not remember a case before where we saw that,” she said. “It was remarkable they were in the heart."
[...]
Of all the coronavirus’s manifestations, its impact on the brain has been among the most vexing. Patients have reported a host of neurological impairments, including reduced ability to smell or taste, altered mental status, stroke, seizures — even delirium.
He [I
saac Solomon, a neuropathologist at Brigham and Women’s Hospital in Boston] found snippets of virus in only some areas [of the brain], and it was unclear whether they were dead remnants or active virus when the patient died. There were only small pockets of inflammation.
But there were large swaths of damage due to oxygen deprivation. Whether the deceased were longtime intensive care patients or people who died suddenly, Solomon said, the pattern was eerily similar.
“We were very surprised,” he said.
[...]
Solomon, whose work was published as a June 12 letter in the New England Journal of Medicine, said the findings suggest the damage had been happening over a longer period of time, which makes him wonder about the virus’s effect on people who are less ill. “
The big lingering question is what happens to people who survive covid,” he said. “Is there a lingering effect on the brain?”
The team from Mount Sinai Health, which took tissue findings from 20 brains, was also perplexed not to find a lot of virus or inflammation. However, the group noted in a paper that t
he widespread presence of tiny clots was “striking.”
“If you have one blood clot in the brain, we see that all the time. But what we’re seeing is, some patients are having multiple strokes in blood vessels that are in two or even three different territories,” Fowkes [
Mary Fowkes, an associate professor of pathology] said.
more at link....
BBM & SBM
I guess that’s better than nothing though.
