Lungs of patients who died from COVID-19 have distinctive features

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In a new study New England Journal of Medicine (NEJM), lead author, Steven J. Mentzer, MD, thoracic surgeon at Brigham and Women’s Hospital, and a team of international researchers examined seven lungs obtained during the autopsy of patients who died from COVID-19. They compared this group to seven autopsied lungs obtained from patients who died from acute respiratory distress syndrome secondary to influenza A (H1N1) infection, and to 10 uninfected control lungs of the same age.
COVID-19 and influenza are both in the same category of viruses and infect the respiratory tract. While the lungs shared some common features, there were distinctive features related to the blood vessels seen in the lungs of patients who died from COVID-19.
The researchers observed that COVID-19 damaged endothelial cells (cells of the vascular mucosa), causing severe endothelial damage. Patients with COVID-19 had generalized blood clotting and new vessel growth – the latter probably being the result of the body’s response to the virus. The team found signs of a distinctive pattern of progression of pulmonary vascular disease in some cases of COVID-19 compared to that of an equally serious influenza virus infection.
Some of the key points are highlighted below:

  • COVID-19 is a respiratory virus that causes vascular disease.
  • Damage to vascular cells helps explain the severe blotting coagulation seen in patients.
  • A unique response, intussusceptive angiogenesis (IA), is how the body compensates for thrombosis and damage to blood vessels.
  • Damaged blood vessels can also cause other problems, such as the COVID toe, children with Kawasaki, stroke and other seemingly unrelated COVID-19 problems.
  • This study shows the need for further research into the angiogenesis and vascular effects of COVID-19.

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