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Blood clots in patients with coronavirus 2:29
(CNN) - Careful autopsies of ten black people who are victims of coronaviruses show that their lungs were clogged with blood clots, researchers reported Wednesday.
All ten patients had underlying conditions that worsened the infection, including high blood pressure, diabetes, and obesity. But genetic factors may also be at stake, the LSU Health New Orleans School of Medicine team said.
The findings, published in Lancet Respiratory Medicine, may help explain why blacks suffer so much more from covid-19 in the United States and in other countries such as Britain, the researchers said.
"We found that the small vessels and capillaries in the lungs were obstructed by blood clots and associated bleeding that contributed significantly to decompensation and death in these patients," Dr. Richard Vander Heide, chief pathology officer at the School, said in a statement. of Medicine.
They also found blood markers called D-dimers, which are signs that the body has been working to break down blood clots.
"I think obesity is important in our population," Vander Heide told CNN. Adipose tissue activates inflammatory chemicals, one of the mechanisms underlying obesity's link to a variety of diseases. The covid-19 infection generates even more inflammation, which doctors believe is involved in the damage caused by covid-19 and, perhaps, the generation of blood clots.
Across the United States, doctors treating patients with covid-19 report that their bodies are riddled with blood clots. Some initial studies have shown that treating patients with blood thinners can help.
READ : Doctors try to understand why they see 'unprecedented' blood clots among covid-19 patients
All ten patients arrived at the hospital after three or seven days of mild cough and fever. Everyone suddenly collapsed or had sudden trouble breathing.
"One of the things people are seeing with covid right now is the cytokine storm that the virus generates," said Vander Heide. Cytokine storm is an avalanche of inflammatory compounds in the immune system that some people produce in response to infection. "We can see it in our sections of the lungs. We see the viral effects in the cells, "he added.
The coronavirus itself could be causing the effect, or affected patients may have their own predisposition to cytokine storms and blood clotting, Vander Heide said. "There could be all kinds of genetic factors," he added.
What pathologists did not see was inflammation of the heart, a consequence of the coronavirus that doctors in China said they saw in their patients.
They also saw no evidence of what is known as secondary infections in the patients. No bacteria or fungus had jumped into the viral car to infect them.
"We also noted that two of our patients were 40 to 50 years younger than those who generally believed they were at risk of death from covid-19," the researchers wrote.
The findings may shed light on why blacks overall suffer more from covid-19 in the UK, wrote Dennis McGonagle of the University of Leeds, and colleagues in a related comment.
“A feature of the 2019 coronavirus disease pandemic has been an increase in mortality among black, Asian and minority ethnic groups in the UK, which has resulted in the UK Government establishing a task force emergency investigation ”, they wrote.
"In the United States, mortality from covid-19 has been particularly high in black communities in large cities."
MIRA : Analysis in New York shows greater impact of covid-19 on Hispanics and blacks
A New Orleans study in the New England Journal of Medicine, also published Wednesday, found that a disproportionate number of patients hospitalized with covid-19 were black. While 31% of the usual patient population in the Ochsner Health system are black, 77% of those treated for coronavirus were black, the researchers reported. And 70% of those who died were black.
"Black patients had higher prevalences of obesity, diabetes, hypertension, and chronic kidney disease than white patients," wrote Dr. Eboni Price-Haywood and his colleagues at Ochsner.
But many factors likely underlie racial discrepancies, they said.
"They may reflect underlying racial differences in the types of jobs that may have an increased risk of community exposure (eg, service occupations)," they wrote. "The racial differences in covid-19 that were observed may also reflect differences in the prevalence of chronic conditions, which appear to increase the risk of serious disease."
Blacks