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

Channel: Doctor Mike Hansen

Views: 9,787,908

Rating: 4.8405824 out of 5

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Id: y6h8TIxeg1g

Length: 13min 43sec (823 seconds)

Published: Thu May 14 2020