Findings in the hearts of deceased COVID-19 patients

A series of 22 autopsies showed that heart damage in COVID-19 deaths had a particular cell death pattern of individual cardiac myocytes and not the typical heart muscle inflammation associated with myocarditis.

Autopsies reveal surprising changes in cardiac tissue in COVID-19 patients

A series of autopsies conducted by pathologists at the Louisiana State University (LSU) Health New Orleans show that heart damage in patients with COVID-19 is not the typical inflammation of the heart muscle associated with myocarditis, but rather a particular pattern of cell death of individual cardiac myocytes. The results come from a detailed study of the hearts of 22 patients who died from COVID-19.

Made in cooperation with our partners from esanum.it

"We have identified the major macroscopic and microscopic changes that challenge the idea that typical myocarditis is associated with severe SARS-CoV-2 infection," says Prof. Richard Vander Heide. "Although the mechanism of cardiac damage in COVID-19 is unknown, we propose several theories that need further investigation to arrive at a better understanding and potential therapeutic interventions” he adds.

The LSU Health Sciences Center's team of pathologists led by Dr. Vander Heide, an experienced cardiovascular pathologist, also discovered that, unlike the coronavirus responsible for SARS, the SARS-CoV-2 virus was not present in heart muscle cells. Nor were there clots in the coronary arteries.

The results of their previous research had revealed that widespread alveolar damage together with thrombus formation and bleeding in pulmonary microcirculation was the major cause of death in COVID-19 patients. "These findings, together with evidence of right ventricular enlargement, may indicate extreme heart stress secondary to acute lung disease," adds Dr. Sharon Fox, Associate Director of Research and Development in the Department of Pathology at LSU Health New Orleans School of Medicine.

Autopsies were conducted at the University Medical Center in New Orleans on 22 patients who died of COVID-19. Most were African-American. The ten male and twelve female patients were aged between 44 and 79 years. Although there were other underlying pathological conditions, the majority had high blood pressure, half had type-2 diabetes treated with insulin and about 41% had obesity.

LSU Health New Orleans pathologists, like others, also found viral infection damage to endothelial cells. Although minimal, this endothelial damage may be sufficient to cause organ dysfunction due to the death of individual cells. The effects of the so-called "cytokine storm" associated with COVID-19 may also play a role in the evolution of the disease. "Since inflammatory cells can pass through the heart without necessarily being present in the actual cardiac tissue, it cannot be excluded that this plays a role in the genesis of cytokine-induced endothelial damage," says Dr. Vander Heide.

Source:
Fox SE, Li G, Akmatbekov A, et al. Unexpected Features of Cardiac Pathology in COVID-19 Infection [published online ahead of print, 2020 Jul 21]. Circulation. 2020;10.1161/CIRCULATIONAHA.120.049465. doi:10.1161/CIRCULATIONAHA.120.049465

Esanum is an online network for approved doctors

Esanum is the medical platform on the Internet. Here, doctors have the opportunity to get in touch with a multitude of colleagues and to share interdisciplinary experiences. Discussions include both cases and observations from practice, as well as news and developments from everyday medical practice.

Esanum ist ein Online-Netzwerk für approbierte Ärzte

Esanum ist die Ärzteplattform im Internet. Hier haben Ärzte die Möglichkeit, mit einer Vielzahl von Kollegen in Kontakt zu treten und interdisziplinär Erfahrungen auszutauschen. Diskussionen umfassen sowohl Fälle und Beobachtungen aus der Praxis, als auch Neuigkeiten und Entwicklungen aus dem medizinischen Alltag.

Esanum est un réseau en ligne pour les médecins agréés

Esanum est un réseau social pour les médecins. Rejoignez la communauté et partagez votre expérience avec vos confrères. Actualités santé, comptes-rendus d'études scientifiques et congrès médicaux : retrouvez toute l'actualité de votre spécialité médicale sur esanum.