Health

Coronavirus autopsy: Small blood clots found in a patient, says a pathologist

Dr. Amy Rapkiewicz, Dean of Pathology at NYU Langone Medical Center, spoke to Erin Burnett at OutFront Thursday night.

Some Covid-19 patients are known to develop blood clotting problems, but the extent and extent to which they occur are described as “dramatic” by Rapkiewicz.

During the early stages of the pandemic, bedside clinicians noticed many blood clots in “a variety of large blood vessels in a row.”

“What I saw at autopsy was like an extension of that,” she said. “Coagulation was found in small blood vessels as well as in large ones.

“And this was dramatic, because we might have expected it in the lungs, but we found it in almost every organ we examined in autopsy studies,” she said. It was Rapkiwich’s study outlining her findings was published in The Lancet journal E Clinical Medicine at the end of June.

Necropsy also showed abnormalities with megakaryocytes, or large bone marrow cells. They usually don’t circulate outside the bones or lungs, Lapkiewicz said.

“We found them in the heart, kidneys, liver and other organs,” she said. “Especially in the heart, megakaryocytes produce what are called platelets, which are closely involved in blood coagulation.”
The researchers hope to find out how these cells affect the coagulation of Covid-19’s small blood vessels, she said.

Pathologists are amazed at something they did not find.

In the early stages of the pandemic, doctors thought the virus would cause myocarditis to cause heart inflammation.

However, the autopsy results in a very low incidence of myocarditis, Lapkiewicz said.

“When the virus had the opportunity to count, pathologists had the opportunity to examine the organs of many Covid-19 victims and investigate the process of the disease that was occurring,” she said. She said opportunities were not really available in the H1N1 and original SARS outbreaks.

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