New York >> The COVID-19 epidemic has helped revive autopsy.
When the virus first arrived in American hospitals, doctors could only guess what a strange constellation of its symptoms was: what could explain why patients were losing their sense of smell and taste, skin redness developing Thea, struggling to breathe and reporting memory loss. Flu-like cough and pain?
Among hospitalists, who have been losing prominence and wealth for several decades in a row, pathologists were busying the first victims of the disease – and finding some answers.
Dr. of NYU Langone. Amy Rapakiewicz said, “We were receiving emails from physicians, desperate in this way asking, ‘What are you looking at?” ‘Autopsy,’ he pointed out, meant looking at oneself. “That’s what we had to do.”
Preliminary autopsy of deceased patients confirmed that coronaviruses not only cause respiratory disease, but may also attack other vital organs. He also led doctors to try to dilute blood in some COVID-19 patients and reconsider how long others should be on ventilators.
Pathologist Dr. at Northwell Health, New York. Alex Williamson said, “You can’t treat it.” “Many people have been saved by watching someone’s death up close.”
Autopsies have given drug information for centuries – helping to reveal the extent of the recent opioid epidemic, improving cancer care, and destroying AIDS and anthrax. Hospitals were once judged by how many autopsies they had performed.
But they have lost stature as the medical world over the years, instead of laboratory tests and imaging scans. In 1950, nearly half of the dead hospital patients were rehearsed. Today, those rates have shrunk to somewhere between 5% and 11%.
Louisiana State University pathologist Drs. “It’s really a lost device,” said Richard Vander Heade.
Some hospitals found it even more difficult this year. Safety concerns about transmission forced many hospital administrators to stop or seriously stop autopsy in 2020. The epidemic led to a general dip in total patients in many hospitals, which reduced autopsy rates in some locations. Larger hospitals across the country are reported to have conducted fewer autopsies in 2020.
In total, from 270 autopsies in recent years to around 200 so far this year, our numbers are quite low. ” Dr. Director of Autopsy and Forensic Services at Michigan Medicine in Ann Arbor. Said Alecia Wilson.
At the University of Washington at Seattle University, pathologist Drs. Desri Marshall could not conduct a COVID-19 autopsy in his normal suit because, as one of the hospital’s oldest facilities, it lacks proper ventilation to conduct this procedure safely. Marshall began borrowing the county medical examiner’s offices for some cases, and has been operating out of the school’s animal research facilities since April.
Other hospitals went into adversity, performing more and more autopsies even under difficult circumstances to try to better understand the epidemic, and there were at least 400,000 American deaths compared to normal deaths.
At New Orleans University Medical Center, where vendor heads work, pathologists have performed about 50% more autopsies in recent years than they did. Other hospitals in Alabama, California, Tennessee, New York and Virginia say they will also exceed their normal annual tally for this procedure.
Their results have shaped our understanding of what COVID-19 does to the body and how we can combat it.
In the spring and early summer, for example, some seriously ill coronovirus patients were on ventilators for weeks at a time. Later, pathologists detected such extended ventilation, which could have caused extensive lung injury, which led doctors to know how they use the ventilator during the epidemic.
Doctors are now exploring whether blood clots can prevent microscopic blood clots that were discovered in early epidemics.
Autopsy studies also indicate that the virus can travel through the bloodstream or ride on infected cells, spreading to a person’s blood vessels, heart, brain, liver, kidney, and colon. This discovery helped explain the wide range of symptoms of the virus.
More conclusions are certain: Pathologists have collected coronovirus-infected organs and tissues during autopsis, which will help researchers to study the disease as well as possible cures and treatments. Future autopsy will also help them understand the disease toll on long-term hulls, which withstand symptoms for weeks or months following infection.
Despite these life-saving discoveries being made during epidemics, financial realities, and a declining workforce, this does not mean that the outbreak of the outbreak will completely reverse the ancient medical practice.
Hospitals are not required to provide autopsy services, and for those who do them, the cost of the procedure is not directly covered by most private insurance or Medicare.
“When you consider that there is no reimbursement for it, it is almost a philanthropic practice,” Rutgers University pathologist Dr. Billy Fieff-Kirschner said. “It’s really important, but we don’t have to fund it.”
Added to the mix: The number of specialists who can actually perform an autopsy is critically low. Estimates suggest that there are only a few hundred forensic pathologists in the US, but may use several thousand – and fewer than 100 graduating medical school students enter the profession each year.
Some hope the 2020 epidemic could boost recruitment in the region – much like the “CSI boom” of the early 2000s, said Williamson of Northwell.
Wilson of Michigan Medicine is more skeptical, but he still cannot imagine his work being completely obsolete. Learning to treat the living from the dead – it’s a pillar of medicine, she said.
This helped doctors understand the mysteries of the 1918 influenza epidemic, just now helping them understand the mysteries of COVID-19 a century later.
“They were in the same position,” Vander Heide told doctors in 1918 about trying to save lives. “The only way to learn was to open and see the body.”