Sunday, May 31, 2020

Know Thy Enemy

Things are really bad when, in order to take your mind off of the terrible news, you decide to take a break by reading about COVID-19. I found an interesting essay about the nature of the ailment- pathologists at NYC's Mount Sinai hospital have conducted autopsies on deceased COVID-19 patients and have release a report on the results of the first sixty-seven procedures. It turns out that the 'Rona is not primarily a respiratory affliction, at least not per se:

COVID-19 was initially conceptualized as a primarily respiratory illness, but the Mount Sinai analysis laid out in detail that it also causes damage to the thin layer of cells that line blood vessels (endothelium), which underlies the clotting abnormalities and hypoxia observed in severely ill patients who develop multi-organ failure that leads to death in some patients.

The lung damage inflicted on the COVID-19 patients is a result of blood clots in the alveoli resulting from this endothelial damage:

The lungs in nearly all cases showed diffuse damage to the alveoli, the small sacs where oxygen and carbon dioxide are exchanged with the blood. This damage is the typical microscopic evidence of clinical acute respiratory distress syndrome (ARDS), with most cases showing fibrin (a fibrous, non-globular protein involved in the clotting of blood) and/or platelet thrombi, or clots, to varying extents. This same pathology is found in most cases of ARDS, including those related to other coronoaviruses. However, the totality of findings in the autopsy series as a whole, with blood clots in multiple other organ systems—most notably the brain, kidney, and liver—reflects endothelial damage as an underlying process, which would also correlate with the activation of the coagulation cascade and persistent elevation of blood markers of inflammation.

This would also explain the Kawasaki Disease-esque symptoms and elevated stroke risk that have been observed in younger COVID-19 patients.

If the clotting is the main peril posed by the 'Rona, maybe anticoagulants can be used to reduce the dangers the virus poses to humans. I think I might have to get in touch with the Leech Guy about this...


Anathema Device said...

Now we need to get the message through to the "it's just a bad flu" crowd.

It's truly a fascinating, if horrifying, disease.

Big Bad Bald Bastard said...

It really is. There was so much that was a mystery about this thing.

Anonymous said...

"Things are really bad when, in order to take your mind off of the terrible news, you decide to take a break by reading about COVID-19."

Dude, that is such an awesome line!

Yeah the Rona was like so 'last week'.