12 COVID Autopsy Cases Reveal the TRUTH How COVID Patients Dying - Doctor Explains

before I say anything I just want to say that if 
you are squeamish you might not want to watch this  

video because there will be some pictures of 
lungs that have a blood clot in them and other  

organs of the body and my opinion is nothing that 
bad but I wanted to give you a warning regardless  

this video is a follow-up to my last video which 
is called what doctors are learning from autopsy  

findings of COVID patients just after I published 
that video not even a day later this study came  

out published in the annals of internal medicine 
which I'll put a link in the description below  

and what makes this study such a big deal is 
that it's the first study that looked at this  

many autopsies of patients who died of COVID not 
only do they do complete autopsies but they use  

CT scans to scan the entire body for blood clots 
all 12 of the deceased had tested positive for  

SARS coronavirus - by means of rt-pcr now I want 
to say something not everyone on this planet is  

going to get COVID for those who do get the virus 
80 percent of them will have either mild or no  

symptoms roughly 15 to 20 percent of them will 
have pneumonia roughly 4 percent will develop  

ARDS or a few respiratory distress syndrome and/or 
shock with multi-organ failure and about 1 percent  

will die of the infection when I'm in the ICU and 
someone dies it's obviously horrible sometimes  

autopsies have to be done irrespective of family 
consent when it's a legal matter rarely depending  

on the circumstances we ask family's permission to 
do an autopsy most families decline the option for  

autopsy but during this pandemic it's especially 
important for autopsies to be done because they  

often provide incredibly valuable information 
especially when we still know so little about  

COVID especially when it can present in so many 
different ways so in this study that was done in  

Germany autopsies were mandated for patients 
who died of coded and to the families of those  

victims of COVID my condolences and we're 
still trying to figure out why some people  

do so poorly when they get the virus while others 
do just fine and then there's everyone in between  

the point of this video is not to scare people 
the point is to learn about the disease and to  

ultimately benefit from that learning with 
the hope of developing treatment options in  

ultimately reduce morbidity and mortality in other 
words to save lives and by making this video the  

goal is to educate myself and others about what 
we're learning and getting the medical truth out  

there to the public so in this study there were 
12 patients total nine men three women and the  

median age was 73 all patients had some type of 
pre-existing medical condition most of them had  

obesity and/or underlying heart disease such as 
coronary heart disease some had type 2 diabetes  

hypertension peripheral artery disease asthma 
COPD initial lab tests revealed elevated levels  

of d-dimer lactate dehydrogenase meaning LD H 
and C reactive protein or CRP all of these are  

nonspecific markers of inflammation there is also 
mild thrombocytopenia in some patients meaning low  

platelet counts this isn't an unusual finding in 
patients who are critically ill they also looked  

at levels of viral RNA using rt-pcr studies all 
twelve patients had the Stars quarter virus to  

RNA in their lungs nine out of the twelve had it 
in their throat and six had in their bloodstream  

in five patients they had viral RNA in other 
tissues like heart liver brain and kidney not  

only did they have the virus there but the levels 
were higher in those tissues compared to the blood  

here's a picture from a different autopsy that 
was not part of this study where the virus was  

actually visualized in the kidney using electron 
microscopy so what is this telling us it tells us  

that the virus is binding to those h2 receptors 
in those organs so in some people who dive COVID 

they had the virus in other organs besides the 
lungs but and this is a big but they did not die  

as a result of that virus being in those different 
organs they died as a result of lung complications  

also an important takeaway from this is that all 
twelve had in their lungs and nine out of the 12  

in their throat so when you go to do a throat 
swab with someone who has COVID the virus might  

not even be there and that's just another reason 
why you can get a false negative test okay so they  

also did post-mortem CT scans of these patients 
which demonstrated mixed patterns of reticular  

infiltrations in severe dense consolidations in 
both lungs this CT scan is a patient with covid  

pneumonia in erred yes not from this study 
that we're talking about now but basically  

demonstrating the exact same thing both lungs have 
extensive consolidations ground-glass opacities  

which represent an extensive inflammation these 
are also known as pulmonary infiltrates and you  

can see the difference compared to a normal 
CT scan of the chest which doesn't have any  

pulmonary infiltrates in four cases out of the 12 
massive pulmonary embolism meaning massive blood  

clots in the pulmonary arteries was the cause of 
death in another three cases out of the 12 they  

had blood clots in their large veins of their legs 
meaning DVT without having pulmonary embolism so  

in six of the nine men they had clots in the veins 
that surround the prostate gland in all 12 cases  

the cause of death was found within the lungs or 
the pulmonary vascular system meaning within the  

pulmonary arteries for the ones who didn't die of 
having a large pulmonary emboli they died of the  

extensive inflammation within the lungs meaning 
pneumonia with ARDS in these cases the lungs were  

wet and heavy much like a sponge that is saturated 
with water the surfaces of the lung often had  

a distinct patchy pattern with pale areas 
alternating with slightly protruding and firm  

deep reddish blue hyper capitalized areas this 
is indicative of areas of intense inflammation  

with endothelial dysfunction that can be seen at 
the microscopic level when they look at slices  

of the lungs under the microscope they found 
diffuse alveolar damage in eight cases out of 12  

specifically they saw hyaline membrane formation 
tiny clots in the capillaries and capillaries  

that were engorged with red blood cells and 
other inflammatory findings all these findings  

represent ARDS they also found lymphocytes 
a type of a white blood cell that infiltrated  

these specific tissues this fits the picture of a 
viral pathogen ASIS they also look at the pharynx  

of these patients meaning the throat the lining of 
the throat where the mucosa was hyperemic meaning  

very red and irritated and at the microscopic 
level they saw lymphocytes invading there as well  

again which is consistent with a viral infection 
in one case a patient had lymphocytes invade his  

heart muscle findings that are consistent with 
what we call viral myocarditis in other words the  

heart muscle had evidence of viral infection more 
than half the patients in this study had large  

blood clots 1/3 of the patients had pulmonary 
embolism as the direct cause of death all the  

others died of intense inflammation in their lungs 
related to pneumonia and ARDS recently there's  

been studies showing that about 1/3 of patients 
with severe COVID have blood clots another study  

of 191 patients with Kovan 19 half of those who 
died had clots compared with 7% of the survivors  

and levels of d-dimer that were greater than 
1,000 were associated with a fatal outcome so  

it's pretty clear now that stars curve to virus 
is causing a lot of class to form and moderate  

to severe COVID disease but how is this happening 
it's likely a combination of reasons they have  

to do with down regulation of the h2 receptor in 
the lung alveoli with a subsequent shift towards  

having more angiotensin 2 in the lungs and less 
angiotensin 1:7 and less in angiotensin 1:9 in  

the lungs and when this happens this leads to 
more cytokine storm with more inflammation more  

constriction of pulmonary arteries and more 
clots that develop that in turn leads to more  

endothelial dysfunction in the capillaries that 
surround the alveoli also there's evidence that  

the virus attaches to the ACE 2 receptors of the 
endothelial cells that line those capillaries  

which further propagates inflammation in clotting 
and in the cytokine storm that develops there  

Randy's Okemo kine bind to the ccr5 receptor 
of cd4 and cd8 lymphocytes and that causes  

those lymphocytes to infiltrate those areas of 
inflammation and in doing so further contributes  

towards the inflammatory reaction this is why 
we're seeing low levels of cd4 and cd8 lymphocytes  

and severe COVID endothelial damage can also lead 
to the development of antiphospholipid antibodies  

and these antibodies are bad because they trigger 
the formation of blood clots and that's why  

patients who have clots with the diagnosis 
of antiphospholipid antibody syndrome they  

need to be on blood thinners also 11 out of the 12 
patients in the study had underlying heart disease  

and were obese these are known risk factors not 
just for cardiovascular disease but also known  

risk factors for endothelial dysfunction in our 
known risk factors for COVID the endothelium is  

more susceptible to damage based on cardiovascular 
risk factors such as men age 45 or older women  

age 55 or older smoking high blood pressure high 
cholesterol diabetes obesity and lack of physical  

activity so the big takeaways from the findings 
in this study is that most people who die of kovat  

it's primarily a lung problem either related to 
inflammation with ARDS and/or blood clots even  

though blood thinners are not a cure for kovat per 
se they do have the potential to save lives the  

hard part is figuring out who is likely to develop 
clots and who should we give blood thinners to and  

which blood thinners should we give and should 
we give high doses of blood thinners or just the  

low-dose prophylactic doses to further complicate 
matters it's often hard to diagnose blood clots in  

hospitalized patients even before COVID came along 
usually it's easy to diagnose large blood clots in  

the veins of the legs meaning DVT by doing an 
ultrasound of the legs even though ultrasound  

isn't a hundred percent accurate the way we 
typically diagnose pulmonary emboli is by getting  

a CT scan of the chest while at the same time 
giving IV contrast and this is called a CT angio  

or CT a of the chest the downsides of doing this 
well there's several one you have to transport a  

patient to the CT scanner and sometimes patients 
aren't stable enough to do that to you risk  

spreading the virus to others in the hospital by 
transporting that pay and this will also require  

more PPE use 3 CT scans require larger doses of 
radiation for giving someone IV contrast has some  

risks such as the risk of serious allergic 
reaction in the risk of causing some kidney  

damage on top of that the CTA of the chest can 
only visualize bigger clots so you might not see  

the small clots that are there right now more and 
more hospitals are giving high-dose blood thinners  

to COVID patients who have severe disease even 
if they haven't been diagnosed as having blood  

clots but what about patients without moderate or 
severe Kovich should they take a blood thinner or  

maybe a low dose blood thinner or should they take 
an antiplatelet medication like aspirin either 81  

milligrams of aspirin or 162 milligram dose or 325 
milligrams os-- or should the general public take  

a low dose aspirin like 81 milligrams in order to 
help prevent blood clots from forming if they do  

get COVID or should it just be certain people in 
the population who are at higher risk of getting  

severe COVID should they take aspirin these are 
the questions we don't know the answers to at  

this point it's going to take a lot of studies 
to answer these questions because not only do  

we need to know that there's a benefit in doing so 
we have to know that these benefits will outweigh  

the risks such as the risk of bleeding and then 
there's all the other drugs that are being looked  

at right now and randomized control trials we 
should start seeing some of these results pretty  

soon what we do know is that in order to improve 
the capillary endothelium and also to minimize  

your chances of having severe disease if you 
were to get COVID you want to do several things  

this includes exercise eating healthy getting 
good sleep minimizing stress not smoking what  

about vaping generally not good either but not as 
bad as smoking too much alcohol not good either  

have your medical conditions under control 
whether that's diabetes high blood pressure  

COPD asthma allergies whatever the case may be 
now what about vitamin D probably a good thing  

but that's a whole nother topic which I should 
make my next video on because there's a lot to  

say about that and possibly other vitamins too 
if you're deficient in certain vitamins anyway  

to catch that video subscribe to this channel and 
hit that Bell notification so you know when I post  

here on YouTube so many topics I want to cover in 
so little time but I will see you in the next one