12 COVID Autopsy Cases Reveal the TRUTH How COVID Patients Dying - Doctor Explains
-
0:00 - 0:02Before I say anything,
I just want to say -
0:02 - 0:06that if you are squeamish
you might not want to watch this video -
0:06 - 0:10because there will be some pictures
of lungs that have a blood clot in them -
0:10 - 0:14and other organs of the body.
In my opinion it's nothing that bad -
0:14 - 0:16but I wanted to give you a warning,
regardless. -
0:16 - 0:19This video is a follow-up
to my last video which was called, -
0:19 - 0:23"What Doctors Are Learning From Autopsy
Findings of COVID Patients. " -
0:23 - 0:28Just after I published that video,
not even a day later, this study came out, -
0:28 - 0:31published in the
Annals of Internal Medicine -
0:31 - 0:33which I'll put a link in to the description below.
-
0:33 - 0:38And what makes this study such a big deal
is that it's the first study that -
0:38 - 0:42looked at this many autopsies of
patients who died of COVID. -
0:42 - 0:46Not only do they do complete autopsies,
but they use CT scans -
0:46 - 0:49to scan the entire body for blood clots.
-
0:49 - 0:53All 12 of the deceased had tested
positive for SARS Coronavirus-2 -
0:53 - 0:56by means of RT-PCR.
-
0:56 - 1:00Now, I want to say something.
Not everyone on this planet is -
1:00 - 1:03going to get COVID.
For those who do get the virus, -
1:03 - 1:0680% of them will either have mild
or no symptoms. -
1:06 - 1:10Roughly 15%-20% of them will
have pneumonia. -
1:10 - 1:14Roughly 4% will develop ARDS, or Acute
Respiratory Distress Syndrome -
1:14 - 1:18and/or shock with
multi-organ failure. -
1:18 - 1:21And about 1% will die of
the infection. -
1:21 - 1:25When I'm in the ICU and
someone dies it's obviously horrible. -
1:25 - 1:29Sometimes autopsies have to be done
irrespective of family consent -
1:29 - 1:31when it's a legal matter.
-
1:31 - 1:33Rarely, depending on the
circumstances, -
1:33 - 1:36we ask familys' permission to
do an autopsy. -
1:36 - 1:39Most families decline the option for
autopsy, -
1:39 - 1:44but during this pandemic, it's especially
important for autopsies to be done -
1:44 - 1:47because they often provide
incredibly valuable information, -
1:47 - 1:51especially when we still know so little
about COVID. -
1:51 - 1:54Especially when it can present in so many
different ways. -
1:54 - 1:56So in this study that was
done in Germany, -
1:56 - 1:59autopsies were mandated for patients
who died of COVID. -
1:59 - 2:03And to the families of those victims
of COVID, my condolences. -
2:03 - 2:07And we're still trying to figure out
why some people do so poorly -
2:07 - 2:10when they get the virus,
while others do just fine -
2:10 - 2:12and then there's everyone in between.
-
2:12 - 2:14So, the point of this video
is not to scare people. -
2:14 - 2:17The point is to learn about
the disease, -
2:17 - 2:19and to ultimately benefit from that
learning -
2:19 - 2:21with the hope of developing treatment
options -
2:21 - 2:27and ultimately reduce morbidity and mortality in other
words to save lives and by making this video the -
2:27 - 2:33goal is to educate myself and others about what
we're learning and getting the medical truth out -
2:33 - 2:40there to the public so in this study there were
12 patients total nine men three women and the -
2:40 - 2:47median age was 73 all patients had some type of
pre-existing medical condition most of them had -
2:47 - 2:54obesity and/or underlying heart disease such as
coronary heart disease some had type 2 diabetes -
2:54 - 3:01hypertension peripheral artery disease asthma
COPD initial lab tests revealed elevated levels -
3:01 - 3:09of d-dimer lactate dehydrogenase meaning LD H
and C reactive protein or CRP all of these are -
3:09 - 3:15nonspecific markers of inflammation there is also
mild thrombocytopenia in some patients meaning low -
3:15 - 3:21platelet counts this isn't an unusual finding in
patients who are critically ill they also looked -
3:21 - 3:28at levels of viral RNA using rt-pcr studies all
twelve patients had the Stars quarter virus to -
3:28 - 3:34RNA in their lungs nine out of the twelve had it
in their throat and six had in their bloodstream -
3:34 - 3:42in five patients they had viral RNA in other
tissues like heart liver brain and kidney not -
3:42 - 3:47only did they have the virus there but the levels
were higher in those tissues compared to the blood -
3:47 - 3:53here's a picture from a different autopsy that
was not part of this study where the virus was -
3:53 - 3:59actually visualized in the kidney using electron
microscopy so what is this telling us it tells us -
3:59 - 4:05that the virus is binding to those h2 receptors
in those organs so in some people who dive COVID -
4:05 - 4:12they had the virus in other organs besides the
lungs but and this is a big but they did not die -
4:12 - 4:18as a result of that virus being in those different
organs they died as a result of lung complications -
4:18 - 4:24also an important takeaway from this is that all
twelve had in their lungs and nine out of the 12 -
4:24 - 4:29in their throat so when you go to do a throat
swab with someone who has COVID the virus might -
4:29 - 4:35not even be there and that's just another reason
why you can get a false negative test okay so they -
4:35 - 4:41also did post-mortem CT scans of these patients
which demonstrated mixed patterns of reticular -
4:41 - 4:48infiltrations in severe dense consolidations in
both lungs this CT scan is a patient with covid -
4:48 - 4:52pneumonia in erred yes not from this study
that we're talking about now but basically -
4:52 - 4:59demonstrating the exact same thing both lungs have
extensive consolidations ground-glass opacities -
4:59 - 5:04which represent an extensive inflammation these
are also known as pulmonary infiltrates and you -
5:04 - 5:08can see the difference compared to a normal
CT scan of the chest which doesn't have any -
5:08 - 5:14pulmonary infiltrates in four cases out of the 12
massive pulmonary embolism meaning massive blood -
5:14 - 5:20clots in the pulmonary arteries was the cause of
death in another three cases out of the 12 they -
5:20 - 5:27had blood clots in their large veins of their legs
meaning DVT without having pulmonary embolism so -
5:27 - 5:34in six of the nine men they had clots in the veins
that surround the prostate gland in all 12 cases -
5:34 - 5:39the cause of death was found within the lungs or
the pulmonary vascular system meaning within the -
5:39 - 5:45pulmonary arteries for the ones who didn't die of
having a large pulmonary emboli they died of the -
5:45 - 5:52extensive inflammation within the lungs meaning
pneumonia with ARDS in these cases the lungs were -
5:52 - 5:57wet and heavy much like a sponge that is saturated
with water the surfaces of the lung often had -
5:57 - 6:04a distinct patchy pattern with pale areas
alternating with slightly protruding and firm -
6:04 - 6:11deep reddish blue hyper capitalized areas this
is indicative of areas of intense inflammation -
6:11 - 6:16with endothelial dysfunction that can be seen at
the microscopic level when they look at slices -
6:16 - 6:22of the lungs under the microscope they found
diffuse alveolar damage in eight cases out of 12 -
6:22 - 6:28specifically they saw hyaline membrane formation
tiny clots in the capillaries and capillaries -
6:28 - 6:33that were engorged with red blood cells and
other inflammatory findings all these findings -
6:33 - 6:38represent ARDS they also found lymphocytes
a type of a white blood cell that infiltrated -
6:38 - 6:45these specific tissues this fits the picture of a
viral pathogen ASIS they also look at the pharynx -
6:45 - 6:50of these patients meaning the throat the lining of
the throat where the mucosa was hyperemic meaning -
6:50 - 6:56very red and irritated and at the microscopic
level they saw lymphocytes invading there as well -
6:56 - 7:02again which is consistent with a viral infection
in one case a patient had lymphocytes invade his -
7:02 - 7:08heart muscle findings that are consistent with
what we call viral myocarditis in other words the -
7:08 - 7:13heart muscle had evidence of viral infection more
than half the patients in this study had large -
7:13 - 7:19blood clots 1/3 of the patients had pulmonary
embolism as the direct cause of death all the -
7:19 - 7:25others died of intense inflammation in their lungs
related to pneumonia and ARDS recently there's -
7:25 - 7:31been studies showing that about 1/3 of patients
with severe COVID have blood clots another study -
7:31 - 7:39of 191 patients with Covid 19 half of those who
died had clots compared with 7% of the survivors -
7:39 - 7:44and levels of d-dimer that were greater than
1,000 were associated with a fatal outcome so -
7:44 - 7:50it's pretty clear now that stars curve to virus
is causing a lot of class to form and moderate -
7:50 - 7:56to severe COVID disease but how is this happening
it's likely a combination of reasons they have -
7:56 - 8:01to do with down regulation of the h2 receptor in
the lung alveoli with a subsequent shift towards -
8:01 - 8:08having more angiotensin 2 in the lungs and less
angiotensin 1:7 and less in angiotensin 1:9 in -
8:08 - 8:14the lungs and when this happens this leads to
more cytokine storm with more inflammation more -
8:14 - 8:20constriction of pulmonary arteries and more
clots that develop that in turn leads to more -
8:20 - 8:25endothelial dysfunction in the capillaries that
surround the alveoli also there's evidence that -
8:25 - 8:30the virus attaches to the ACE 2 receptors of the
endothelial cells that line those capillaries -
8:30 - 8:36which further propagates inflammation in clotting
and in the cytokine storm that develops there -
8:36 - 8:43Randy's Okemo kine bind to the ccr5 receptor
of cd4 and cd8 lymphocytes and that causes -
8:43 - 8:49those lymphocytes to infiltrate those areas of
inflammation and in doing so further contributes -
8:49 - 8:55towards the inflammatory reaction this is why
we're seeing low levels of cd4 and cd8 lymphocytes -
8:55 - 9:02and severe COVID endothelial damage can also lead
to the development of antiphospholipid antibodies -
9:02 - 9:08and these antibodies are bad because they trigger
the formation of blood clots and that's why -
9:08 - 9:13patients who have clots with the diagnosis
of antiphospholipid antibody syndrome they -
9:13 - 9:19need to be on blood thinners also 11 out of the 12
patients in the study had underlying heart disease -
9:19 - 9:25and were obese these are known risk factors not
just for cardiovascular disease but also known -
9:25 - 9:31risk factors for endothelial dysfunction in our
known risk factors for COVID the endothelium is -
9:31 - 9:38more susceptible to damage based on cardiovascular
risk factors such as men age 45 or older women -
9:38 - 9:47age 55 or older smoking high blood pressure high
cholesterol diabetes obesity and lack of physical -
9:47 - 9:52activity so the big takeaways from the findings
in this study is that most people who die of Covid -
9:52 - 10:00it's primarily a lung problem either related to
inflammation with ARDS and/or blood clots even -
10:00 - 10:05though blood thinners are not a cure for Covid per
se they do have the potential to save lives the -
10:05 - 10:10hard part is figuring out who is likely to develop
clots and who should we give blood thinners to and -
10:10 - 10:15which blood thinners should we give and should
we give high doses of blood thinners or just the -
10:15 - 10:22low-dose prophylactic doses to further complicate
matters it's often hard to diagnose blood clots in -
10:22 - 10:28hospitalized patients even before COVID came along
usually it's easy to diagnose large blood clots in -
10:28 - 10:34the veins of the legs meaning DVT by doing an
ultrasound of the legs even though ultrasound -
10:34 - 10:39isn't a hundred percent accurate the way we
typically diagnose pulmonary emboli is by getting -
10:39 - 10:46a CT scan of the chest while at the same time
giving IV contrast and this is called a CT angio -
10:46 - 10:52or CT a of the chest the downsides of doing this
well there's several one you have to transport a -
10:52 - 10:58patient to the CT scanner and sometimes patients
aren't stable enough to do that to you risk -
10:58 - 11:03spreading the virus to others in the hospital by
transporting that pay and this will also require -
11:03 - 11:12more PPE use 3 CT scans require larger doses of
radiation for giving someone IV contrast has some -
11:12 - 11:17risks such as the risk of serious allergic
reaction in the risk of causing some kidney -
11:17 - 11:23damage on top of that the CTA of the chest can
only visualize bigger clots so you might not see -
11:23 - 11:28the small clots that are there right now more and
more hospitals are giving high-dose blood thinners -
11:28 - 11:33to COVID patients who have severe disease even
if they haven't been diagnosed as having blood -
11:33 - 11:38clots but what about patients without moderate or
severe Covid should they take a blood thinner or -
11:38 - 11:45maybe a low dose blood thinner or should they take
an antiplatelet medication like aspirin either 81 -
11:45 - 11:52milligrams of aspirin or 162 milligram dose or 325
milligrams os-- or should the general public take -
11:52 - 11:58a low dose aspirin like 81 milligrams in order to
help prevent blood clots from forming if they do -
11:58 - 12:02get COVID or should it just be certain people in
the population who are at higher risk of getting -
12:02 - 12:07severe COVID should they take aspirin these are
the questions we don't know the answers to at -
12:07 - 12:12this point it's going to take a lot of studies
to answer these questions because not only do -
12:12 - 12:16we need to know that there's a benefit in doing so
we have to know that these benefits will outweigh -
12:16 - 12:21the risks such as the risk of bleeding and then
there's all the other drugs that are being looked -
12:21 - 12:25at right now and randomized control trials we
should start seeing some of these results pretty -
12:25 - 12:31soon what we do know is that in order to improve
the capillary endothelium and also to minimize -
12:31 - 12:36your chances of having severe disease if you
were to get COVID you want to do several things -
12:36 - 12:44this includes exercise eating healthy getting
good sleep minimizing stress not smoking what -
12:44 - 12:50about vaping generally not good either but not as
bad as smoking too much alcohol not good either -
12:50 - 12:55have your medical conditions under control
whether that's diabetes high blood pressure -
12:55 - 13:02COPD asthma allergies whatever the case may be
now what about vitamin D probably a good thing -
13:02 - 13:07but that's a whole nother topic which I should
make my next video on because there's a lot to -
13:07 - 13:13say about that and possibly other vitamins too
if you're deficient in certain vitamins anyway -
13:13 - 13:18to catch that video subscribe to this channel and
hit that Bell notification so you know when I post -
13:18 - 13:24here on YouTube so many topics I want to cover in
so little time but I will see you in the next one
- Title:
- 12 COVID Autopsy Cases Reveal the TRUTH How COVID Patients Dying - Doctor Explains
- Description:
-
Careful: before translating the subtitles, here, bear in mind that translated subtitles are already available on YouTube in: Arabic, Chinese, Filipino, Finnish, French, German, Hindi, Japanese, Korean, Norwegian, Romanian, Spanish and Swedish
By Dr Mike Hansen
Original YouTube description:
In all 12 COVID Autopsy cases, the cause of death was found within the lungs or the pulmonary vascular system. Those who did not die of large pulmonary emboli died of extensive inflammation, meaning pneumonia with ARDS. In these COVID Autopsy cases, the lungs were wet and heavy, much like a saturated water sponge. The lung surfaces often had a distinct patchy pattern, with pale areas alternating with slightly protruding and firm, deep reddish-blue Hypercapillarized areas. This indicates areas of intense inflammation, with endothelial dysfunction that can be seen at the microscopic level. When they look at the lungs' slices under the microscope, they found diffuse alveolar damage in 8 COVID Autopsy cases. Specifically, they saw hyaline membrane formation, tiny clots in the capillaries, capillaries engorged with red blood cells, and other inflammatory findings. All these findings represent ARDS. They also found lymphocytes, a type of white blood cell, infiltrated these areas of infiltration. This fits the picture of viral pathogenesis.
⏩ Timestamps, click to skip ahead: 12 COVID Autopsy Cases Reveal!
00:00 - Introduction
02:38 - The starting point of the COVID Autopsy Analysis
04:10 - Why we get COVID false Negative Test
04:34 - Rest of the Part of COVID Autopsy Analysis
09:45 - Big Takeaway's from the Findings in this COVID Autopsy Study
12:30 - Minimize the chances of having the severe disease if you were to get COVIDThis is the link to the main study in this video:
https://www.acpjournals.org/doi/10.73...They also looked at the pharynx of these COVID patients, meaning in their throat. The lining of the throat, or mucosa, was hyperemic, meaning very red and irritated. At the microscopic level, they saw lymphocytes invading there, which is consistent with a viral infection. In one COVID case, a COVID patient had lymphocytes invade his heart muscle, findings that are consistent with what we call viral myocarditis. More than half of the COVID patients in this study had large blood clots. One-third of the COVID patients had pulmonary embolism as the direct cause of death. All the others died of intense inflammation in their lungs related to pneumonia with ARDS (Acute Respiratory Distress Syndrome). Recently, studies show that about 1/3rd of COVID patients with severe COVID have blood clots. In another study of 191 COVID patients, half of those who died had clots, compared with 7% of survivors. And levels of D-dimer that were greater than 1000 µg/L were associated with a fatal outcome. So it's pretty clear now that the COVID has caused many clots to form in moderate to severe COVID disease.
How is this happening?
It's likely a combination of reasons that have to do with downregulation of the ACE2 receptor in the lung alveoli, with a subsequent shift towards having more angiotensin II in the lungs, and less angiotensin 1-7 and 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 is evidence that the virus attaches to the ACE2 receptors of those endothelial cells that line those capillaries, which further propagates inflammation and clotting. And in the cytokine storm that develops there, RANTES, a chemokine, binds 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 are seeing low levels of CD4 and CD8 lymphocytes in severe COVID. Endothelial damage can also lead to the development of antiphospholipid antibodies, and these antibodies are bad because they trigger blood clot formation. That’s why COVID patients who have clots with antiphospholipid antibody syndrome need to be on blood thinners.11 out of the 12 COVID patients in this study had underlying heart disease and were obese. These are known risk factors for cardiovascular disease and known risk factors for endothelial dysfunction and are known risk factors for COVID. So the big takeaways from the findings in this study are that most people who die of COVID are primarily lung problems. Either related to inflammation with ARDS and/or blood clots.
Antiphospholipid syndrome might be a commonality among patients with thrombosis in COVID patients.
Doctor Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine
Website: https://doctormikehansen.com/
IG Account: http://instagram.com/doctor.hansen/
FB Page: https://www.facebook.com/DoctorMikeHa... - Video Language:
- English
- Team:
- Captions Requested
- Duration:
- 13:43