Covid-19 autopsy becomes an important source of information for treating patients: Report

Among the most important findings are confirmations that the coronavirus appears to be the most violent attack on the lungs.

Researchers have also found extensive coagulation in organs such as the kidneys, liver, digestive tract, and spleen of the brain, and in the endothelial cells that line blood vessels.

“That’s what we don’t see,” said Mary Fowkes, an associate professor of pathology, a member of Mount Sinai Health’s team who autopsied 67 COVID-19 patients. I am.

When it comes to the heart, many doctors have for several months warned of myocarditis, cardiac complications that were suspected to be inflammation or hardening of the myocardial wall, but autopsy researchers have shown that I was surprised that I couldn’t find any evidence.

At best, Post reported that autopsy can reconstruct the natural course of the disease, but the process of new and infectious diseases is tedious and requires careful work.

Special tools are needed to protect the pathologist. They need to cut out a cross section of each organ and collect a small piece of tissue for study with different types of microscopes.

Richard Vanderheide, who has been autopsy since 1994, remembers the day he autopsied a 44-year-old coronavirus patient who had been treated with LSU Heath. After cutting the lungs, he found hundreds or thousands of microthrombus.

“I will never forget that day,” recalled Heide, who has been autopsy since 1994.

“I told the resident, “This is very unusual.” I’ve never seen anything like this.” But he noticed a similar pattern in his next patients.

He shared the paper online before submitting it to the journal, making the information available to doctors.

His revelation caused a turmoil in many hospitals, and giving blood thinners became a common practice.

The final peer-reviewed version with 10 patients was then published in May at Lancet.

The next organ studied closely was the heart. One of the most dreadful early reports of coronavirus from China was that a significant proportion (up to 20-30%) of hospitalized patients appeared to have myocarditis, which could lead to sudden death.

Fowkes from Mount Sinai, and her colleague’s study of 25 hearts, are online, but yet to be peer-reviewed Claire Breath found “very mild” inflammation on the surface of the heart. But he didn’t look like myocarditis.

NYU Langone’s Rapkiewicz, who studied seven hearts, was shocked by the abundance of rare cells called megakaryocytes in the heart. The cells that produce platelets that control coagulation are usually found only in the bone marrow and lungs.

“We couldn’t remember the case before we saw it. It was amazing they were in our hearts,” she said.

Patients have reported many neurological disorders, including decreased odor and taste, altered mental status, stroke, seizures, and even delirium.

An early Chinese study published in the BMJ (formerly the British Medical Journal) in March found that 22% of 113 patients experienced neurological problems ranging from excessive drowsiness to coma and were usually conscious. I have found that it is grouped as an obstacle.

Isaac Solomon, a neuropathologist at Brigham and Women’s Hospital in Boston, performed an autopsy of 18 consecutive deaths, cerebral cortex (gray matter involved in information processing), thalamus (regulating sensory input), basal cerebrum. Nuclear (responsible) for motor control etc. Each was divided into a 3D grid. Ten sections were retrieved and surveyed from each.

He found fragments of the virus only in some areas, and when the patient died, it was unclear whether they were dead remnants or active viruses.

Jeffrey Burger, a cardiologist at New York University, who runs a National Institutes of Health funded laboratory focused on platelets.

At autopsy, anticoagulants and anticoagulants may help reduce the effects of COVID-19, according to Berger. He is also leading a major clinical trial investigating the optimal dose of anticoagulant to address the issue.

“This is just one part of a very large puzzle and there’s a lot to learn,” he said.

“But if we can prevent serious complications and more patients withstand the infection, that will change everything,” he added.

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