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LSU Health releases findings of COVID-19 death autopsies on local patients; small vessels in lungs found to have blood clots

Updated: May. 27, 2020 at 7:19 PM CDT
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LSU Health New Orleans sign on building.
LSU Health New Orleans sign on building.(Source: WVUE)

NEW ORLEANS, La. (WVUE) -LSU Health New Orleans released its findings on a series of autopsies it performed on local patients who died from COVID-19, the majority being African American. LSU believes it was the first in the U.S. to conduct a series of autopsies on blacks that discovered blood clots contributed to the patients’ deaths.

"I've never seen a virus so repeatedly causing this blood vessel damage in the lungs,” said Dr. Sharon FOX, Associate Director of Research in the Department of Pathology at LSU Health New Orleans School of Medicine.

The autopsies were conducted at University Medical Center in New Orleans. They found small vessels and capillaries were obstructed by blood clots.

Dr. Richard Vander Heide is Director of Pathology Research at LSU Health New Orleans School of Medicine and senior author of the study.

"We’ve done 26 and just about everyone has blood clots to different degrees,” Vander Heide said of the autopsies on the COVID-19 victims.

He was asked about his initial reaction to finding blood clots in the lungs of the deceased they examined.

"Well, we were surprised because the hemorrhage or the blood was quite significant too and that was unusual. I remember saying to the resident I was doing the first case with, I said, I've never seen hemorrhage like this associated with, you know, these types of changes. I said, something's going on here that's different,” said Vander Heide.

Fox agreed.

"What was unexpected and really important from our autopsy series and an early finding that we were able to share was there was significant blood clotting happening in the small blood vessels in the lungs as well as damage to the blood vessels,” said FOX. "There are small blood clots that are causing the lungs to be unable to exchange gases like oxygen and carbon dioxide."

LSU says the small vessel clotting is a new finding that appears to be specific to COVID caused by SARS-CoV-2 which is the official name of COVID-19.

"In my opinion, every one of these COVID cases, the cause of death is respiratory failure and that is directly the consequence of the inflammation in the lungs as well as the hemorrhage that's in the lungs,” Vander Heide said.

Blood clots impede blood flow and can have deadly consequences.

"The problem is that of course the lung requires air space to exchange for people to live and so when you get fluid and blood into those spaces the lungs can't do their job and then the patients get very short of breath and they start to need to be intubated and they end up in respiratory failure which is what we see with most of these patients,” Vander Heide stated.

LSU Health says its study presents a large series of autopsies within a specific demographic that is experiencing the highest rate of adverse outcomes in the U.S.

"Of course, it reflects our patient population but again I would also tell you that the age range is very striking amongst the African American population,” said Vander Heide. "It seems to be affecting African Americans at a younger and more severe stage of it than it does other groups."

The decedents upon whom the autopsies were performed were male and female and between 40 and 70 years old. LSU pathologists say many had a history of hypertension, obesity, diabetes, and chronic kidney disease.

Still, LSU says the life-threatening blood clotting could affect people across the racial spectrum who are battling COVID-19.

“Yes, yes, it certainly can,” said Vander Heide.

LSU’s findings were published in the journal, The Lancet Respiratory Medicine on Wednesday (May 27).

"It's probably fair to say that we were the first U.S. group to publish those findings,” said Vander Heide.

And the LSU doctors said they also made important discoveries about the decedents' hearts.

"There were lots of reports that some patients were dying directly of inflammation of the heart and so we were very interested to find out whether that was the case in our patient population and we hadn't seen that, so, we're really not seeing that inflammation of the heart or myocarditis that's been reported by groups and China and some other groups and so we think that's very interesting as well,” said Vander Heide.

And they believe their findings will help the broader healthcare community.

"They’re looking more at anti-coagulation therapies and other things that are really kind of the result of what these autopsies have shown,” said Vander Heide.

"A clue as to how to better treat patients with COVID-19,” said Fox of their work.

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