Autopsies reveal surprising cardiac changes in COVID-19 pati
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A series of autopsies conducted by LSU Health New Orleans pathologists shows the damage to the hearts of COVID-19 patients is not the expected typical inflammation of the heart muscle associated with myocarditis, but rather a unique pattern of cell death in scattered individual heart muscle cells. They report the findings of a detailed study of hearts from 22 deaths confirmed due to COVID-19 in a Research Letter published in Circulation.

While the mechanism of cardiac injury in COVID-19 is unknown, researchers propose several theories that bear further investigation that will lead to greater understanding and potential treatment interventions.

They also found that unlike the first SARS coronavirus, SARS-CoV-2 was not present in heart muscle cells. Nor were there occluding blood clots in the coronary arteries.

These findings, along with severely enlarged right ventricles, may indicate extreme stress on the heart secondary to acute pulmonary disease.

The autopsies, believed to be some of the first reported from the US, found viral infection of some of the cells in the lining of the smaller blood vessels (endothelium). Although at low levels, it may be enough to cause dysfunction leading to individual cell death. The effects of the so-called "cytokine storm" associated with COVID may also play a role.

"Given that inflammatory cells can pass through the heart without being present in the tissue proper, a role for cytokine-induced endothelial damage cannot be ruled out," said researchers.

Source: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.049465
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