7 May 2020

Adding to the growing evidence of abnormal blood clotting and strokes etc.  in COVID-19 patients is a German study looking at the results of autopsies of 12 consecutive patients who died from COVID-19.

The 12 patients all had laboratory-confirmed COVID-19 and had a median age of 73. All of the patients had pre-existing chronic medical conditions, such as obesity, coronary heart disease, asthma, COPD, peripheral artery disease and type 2 diabetes.

Lab test results were available for 10 of the 12 patients and showed high levels of lactate dehydrogenase (indicates tissue damage), D-dimer (indicates blood clot formation and breakdown), and C-reactive protein (indicates inflammation or infection). Four patients had mild thrombocytopenia (low levels of platelets – blood cells that help blood clot).

Autopsy found that 7 of the 12 patients had a deep vein thrombosis (DVT), which had not been suspected before death. Four of these patients died from a massive pulmonary embolism (a blockage in an artery in the lung) with the clots arising from the lower limbs.  In all the patients with DVT, both legs were involved.

Most of the lungs were congested and heavy – the average weight of both left and right lungs combined was 1988 grams.  Standard combined lung weights for men and women are 840 g and 639 g, respectively. The authors say that their findings of heavy, consolidated and basically air-free lungs in most cases explain the difficulties in sufficiently ventilating some of the patients.

The authors found the highest level of virus at the back of the throat and in the lungs, but 5 patients also had high levels in the liver, kidney and heart.

The authors concede that they looked at a small number of patients, but conclude that there was a high incidence of thromboembolic events (basically blood vessel clots that arise in the body and which can travel to other blood vessels and block them).

They suggest that some patients with COVID-19 who show certain signs might benefit from anticoagulant treatment – and that more studies are needed to confirm their results.

Last Reviewed: 07/05/2020

myDr


References

1. Wichmann D, Sperhake J, Lütgehetmann M, et al. Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study. Ann Intern Med. 2020; [Epub ahead of print 6 May 2020]. doi: https://doi.org/10.7326/M20-2003