Thrombosis, lung injury in patients dying of COVID-19; confirm findings | Health News

Washington DC: In 10 autopsies performed on patients with confirmed COVID-19, all patients had lung damage and premature lung scarring, as well as kidney damage as a result of the virus .. Nine patients also had thrombo-thrombosis in at least one major organ (heart, lungs, or kidneys).

The team was unable to investigate the thrombosis in the 10th patient. The research team behind the study believes this finding will help guide clinicians in treating complications as a result of COVID-19, including using anticoagulants to prevent the development of blood clots. I am.

They also hope that a better understanding of the major complications of severe cases can help clinicians develop new ways to monitor and treat the disease.

Presented at The Lancet Microbe, the study was led by researchers at Imperial College London and the Imperial College Healthcare NHS Trust. Although the number of patients tested is small, this is the largest study to date on post-mortem examinations for COVID-19 patients in England.

Dr. Michael Osbourne, an honorary senior clinical lecturer at Imperial College London, consultant pathologist and co-author of the study at the Imperial College Healthcare NHS Trust, said: “COVID-19 is a new disease and had limited opportunities for comprehensive tissue analysis. From patients for anatomical purposes, to better understand what caused the patients’ illness and death for research purposes.”

“Our study is the first country to support an existing theory from ward researchers and doctors that lung damage, thrombosis, and immune cell depletion are the most prominent features in severe cases of COVID-19. In his research, he also found evidence of renal damage, and sometimes pancreatitis. These other findings help clinicians develop new strategies for managing patients. He added.

“An autopsy-based analysis of COVID-19 for the study is essential to learn more about the disease as the pandemic progresses. We agree with this study and appreciate the medical advances that generosity brings. Our work is working with colleagues at the Royal Pathologist College to develop national guidelines for the autopsy of COVID-19 patients and to accelerate the system for further study in the future. In anticipation of the potential second wave of cases introduced, we hope that a better understanding of the nature and cause of the disease will lead to more effective treatment and reduced mortality.”

Dr. Bryan Hanley, a co-author of the study from the Department of Cytopathology at the Imperial College Healthcare NHS Trust, said: “The United Kingdom sadly causes a large number of deaths associated with COVID-19. The search for effective treatments helps us understand how illness affects our body.”

“Postmortem examination is crucial in this regard. The findings in this study support studies in other autopsy groups worldwide and in the United Kingdom that describe the structural damage to organs caused by COVID-19. It also records some unexpected complications: Understanding COVID-19 helps clinical teams manage severe cases and also monitors and treats additional complications as a result of the disease. can do.”

During the lockdown period, researchers throughout the country had very limited opportunities to perform post-mortem examinations for research purposes on patients who died of illness. The team wanted to see if tissue samples from patients who died as a result of severe COVID-19 could collect new insights about how the virus infects cells of the body.

The team performed post-mortem examinations and biopsies on 10 patients aged 22 to 97 years at the Imperial College Healthcare NHS Trust hospital from March to June. Complete consent after death with extensive tissue sampling and use of the tissue for research was sought by deceased relatives and friends in line with national protocols.

Seven of the patients were male and four were female. Six of the patients were BAME background and four were Caucasian. In patients studied, hypertension and chronic obstructive pulmonary disease-the name of the group of lung conditions that cause dyspnea-was the most common cause of death.

All patients had fever and had at least two respiratory symptoms early in the disease, such as coughing and shortness of breath. Most patients died within 3 weeks of symptom onset and treatment varied by cohort.

The research team also reported on six key findings.

1. All patients showed diffuse alveolar damage (DAD). DAD is a term used to describe the pattern of lung damage seen as a result of viral infection. This type of lung damage can affect both gas exchange (oxygen and carbon dioxide) and pulmonary blood flow.

2. All of the 9 out of 10 patients who were completely evaluated showed some form of thrombosis-thrombosis-in at least one major organ (thrombotic study of the 10th patient was investigated) I couldn’t do that). Thrombosis interferes with the normal flow of blood through the circulatory system and can cause strokes and heart attacks.

The researchers found blood clots in the lungs of 8 patients, the heart of 5 patients, and the kidneys of 4 patients. They support the theory that this causes COVID-19 to cause cardiovascular complications and believe that treatment of patients can be augmented with anticoagulants to prevent blood clots.

3. All patients had evidence of acute renal tubular dysfunction-renal dysfunction or renal dysfunction that can cause renal dysfunction. The main causes are low blood flow to the kidneys and severe infections. It often affects patients in hospitals and intensive care units.

4. T lymphocyte depletion (TLD) in the spleen and lymph nodes was another consistent finding. T lymphocytes (white blood cells) are a major component of the immune system and are involved in the destruction of infections. TLD is a decrease in T lymphocytes that alters the immune system and its response. Hemophagocytosis is another consistent finding in this group, which occurs when the immune system overreacts to an infection and destroys some of its own cells.

5. Researchers found evidence of acute pancreatitis in two patients. Acute pancreatitis is a condition in which the pancreas is inflamed. It can be treated with intravenous fluids, but in some cases it can lead to serious complications and organ failure. Although no damage to the pancreas of COVID-19 patients has been previously reported, it is not clear in this study whether pancreatitis was associated with COVID-19 infection or other causes.

6. The researchers also found evidence of a rare fungal infection in one of the patients called mucormycosis. Mucormycosis is an infection that can spread through the bloodstream and affect other parts of the body. Severe infections involve other organs such as the lungs, brain, kidneys, spleen, and heart. The team is working with various research groups at home and abroad to conduct a more detailed analysis of these organizations and hopes that the study will be expanded to include a broader range of patients.