Autopsis reveals surprising cardiac changes in COVID-19 patients


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A series of autopsy conducted by LSU Health New Orleans pathologists shows damage to the hearts of COVID-19 patients, not the expected specific inflammation of the heart muscle associated with myocarditis, but rather a cell death in scattered individual cardiac muscle cells. Unique pattern. They report the findings of a detailed study of hearts from 22 deaths confirmed due to COVID-19 in published research paper Spreading, available here.

Richard Vander Heyd, MD and director of pathology research at LSD Health New Orleans, says, “We have identified major macro and subtle changes that challenge the notion that specific myocarditis is present in severe SARS-CoV-2 infections. ” School of Medicine. “While the mechanism of heart injury in COVID-19 is unknown, we propose several theories that bear further investigation that would lead to greater understanding and potential treatment interventions.”

An experienced cardiologist, Dr. The team of LSU Health Pathologists led by Vander Heyd also found that unlike earlier SARS coronoviruses, SARS-COV-2 was not present in cardiac muscle cells. And neither were preventing blood clots in the coronary arteries.

Their previously reported results suggest that alveolar damage (DAD) has spread – causing damage to the small airways of the lungs where gas is exchanged – as well as blood clots and small lung blood vessels and capillaries. Bleeding was the major contributor to death.

“These findings, along with severely enlarged right ventricles, may indicate excessive stress on secondary to acute pulmonary disease of the heart,” Sharon Fox, MD, Associate Director of Research and Development at the Department of Pathology at LSU Health Department , Says Ph.D. New Orleans School of Medicine.

The autopsy, believed to be some of the first reports from the US, was conducted on 22 patients who died of COVID-19 at University Medical Center in New Orleans. The majority were African American. Ten male and twelve female patients were aged between 44–79. Although there were other underlying conditions, most had hypertension, half had insulin-treated type 2 diabetes, and about 41% had obesity.

LSU Health New Orleans pathologists, as others, have also found viral infections of some cells in the lining of small blood vessels (endothelium). However at low levels, it can lead to different cell death dysfunction. The effects of the so-called “cytokine storm” (severe degradation of infection-fighting immune system cells) associated with COVID may also play a role.

Dr. “Given that inflammatory cells can pass through the heart without being present in tissue, the role of cytokine-induced endothelial damage cannot be ruled out,” says Vander Heide.

In addition to DRS. Vander Heyd and Fox, the LSU Health New Orleans team included pathology resident Abek Akmatbakov, MD; Fernanda S. Lamira, MD; And Jack L. Herbert, MD. Gulen Lee, and Jay Quincy Brown of Tulane also attended.


The first COVID-19 autopsy series reveals new cardiopulmonary findings


more information:
Sharon E. Fox et al., Unexpected features of cardiac pathology in COVID-19 infection, Spreading (2020). DOI: 10.1161 / CIRCULATIONAHA.120.049465

Provided by Louisiana State University

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