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COVID-19: Pulmonary embolism as a common cause of death

COVID-19: Pulmonary embolism as a common cause of death


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COVID-19 sufferers: increased rate of thrombosis and pulmonary embolism

COVID-19 leads to thrombosis and pulmonary embolism in an unusually large number of illnesses. This has been shown by a study by scientists from Hamburg. The new findings could lead to changes in treatment recommendations for people suffering from coronavirus.

A few days ago, a scientific study by an international research team was published in the journal "Radiology", in which complications from blood clots in SARS-COV-2 infections were reported. Now researchers from Germany have found an increased rate of thrombosis and pulmonary embolism in people with COVID-19 infections.

An unusually large number of illnesses led to pulmonary embolism

According to a recent announcement, the Institute of Forensic Medicine at the University Medical Center Hamburg-Eppendorf (UKE) conducts a large number of autopsies of patients with COVID-19 infections.

The research teams led by Prof. Dr. Klaus Püschel, Director of the Institute of Forensic Medicine, and Prof. Stefan Kluge, Director of the Clinic for Intensive Care Medicine, point out that COVID-19 led to thrombosis and pulmonary embolism in an unusually large number of illnesses.

The results of the study of the first twelve patients were published in the renowned journal "Annals of Internal Medicine".

Almost all of the deceased had previous illnesses

As stated in the communication, only the autopsy of COVID-19 deceased can be used to reconstruct disease courses, determine the causes of death and concomitant diseases can be recorded in detail.

The post-mortems carried out so far show that almost all of the deceased had previous diseases, for example of the cardiovascular system or the lungs. However, the physicians saw a series of COVID-19 that had not yet been perceived to this extent: pulmonary embolism and thrombosis.

"In the post-mortem examination of the first 12 deceased, we were able to demonstrate that there was an unexpectedly high rate of fatal pulmonary embolism. In addition, more than half of the patients had thrombosis of the leg veins," explains Prof. Jan Sperhake, senior physician at the Institute of Forensic Medicine and first author the study.

This was already clinically suspected by the researchers, has now been scientifically proven in the autopsy of the first twelve patients and has been confirmed in the course of a total of 192 forensic medical examinations.

The SARS-CoV-2 virus therefore appears to lead to the formation of blood clots in the veins, which enter the large pulmonary vessels as so-called pulmonary embolism and can lead to acute cardiovascular failure.

Patients should be given blood thinners

It has not yet been finally clarified which factors are actually responsible for COVID-19 patients forming blood clots with an above-average frequency.

However, the studies provide information on how to improve the treatment of COVID-19 sufferers.

"We are considering whether, according to individual risk assessment, these patients should be treated primarily with a blood thinner to avoid thrombosis and pulmonary embolism in the future," says Priv.-Doz. Dominic Wichmann, senior physician in the intensive care clinic and also first author of the study.

“This requires further study results. In order to really prove a benefit for the patient, a larger randomized study is required. "

Autopsies of COVID-19 deceased

According to the message, the careful examination of the dead has been taking place since March 23 and proves that the majority of the deceased were previously physically or immunologically severely impaired patients.

Many of those affected had previous diseases of the heart, lungs and kidneys as well as metabolic diseases (e.g. diabetes mellitus), cancer or dementia. Pneumonia with or without pulmonary embolism was always the cause of death. In the meantime, however, some virus-positive deaths with COVID-19-independent cause of death have occurred.

According to the data, the age and gender distribution of the 192 deceased examined at the Institute of Forensic Medicine has so far shown a ratio of around 44 percent women and 56 percent men. The average age of the deceased is therefore 80 years (range 31-99 years); 77 years for men and 82 years for women. (ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • University Medical Center Hamburg-Eppendorf (UKE): UKE study shows increased rate of thrombosis and pulmonary embolism in COVID-19 patients, (accessed: May 9, 2020), University Medical Center Hamburg-Eppendorf (UKE)
  • Dominic Wichmann, Jan-Peter Sperhake, et al .: Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study; in: Annals of Internal Medicine, (published: 06.05.2020), Annals of Internal Medicine
  • Matthijs Oudkerk, Harry R Büller, Dirkjan Kuijpers, Nick van Es, Sitse F Oudkerk et al.:Diagnosis, Prevention, and Treatment of Thromboembolic Complications in COVID-19: Report of the National Institute for Public Health of the Netherlands; in: Radiology, (published: April 23, 2020), Radiology


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