(CNN) – A cautious autopsy of 10 African-American coronavirus victims showed their lungs were blocked by blood clots, researchers reported Wednesday.
All 10 patients have underlying conditions that have been proven to worsen infections, including high blood pressure, diabetes and obesity. But genetic factors can also play a role, the team at LSU Health’s New Orleans School of Medicine said.
Findings published in Lancet Respiratory Medicine, could help explain why black people suffer far more than Covid-19 in the US and in several other countries such as Britain, the researchers said.
“We found that small vessels and capillaries in the lungs were blocked by blood clots and associated bleeding which significantly contributed to decompensation and death in these patients,” Dr. Richard Vander Heide, head of pathology at medical school, said in a statement. .
They also found a blood marker called D-dimer, which is a sign that the body has been working to break up blood clots.
“I think obesity is important in our population,” Vander Heide told CNN. Fat tissue activates inflammation chemicals – one of the mechanisms underlying obesity’s relationship with various diseases. Covid-19 infection produces more inflammation, which doctors say is involved in damage caused by Covid-19 and, possibly, the generation of blood clots.
Throughout the US, doctors treating patients with Covid-19 report that their bodies are full of blood clots. Some preliminary research shows that treating patients with anticoagulants can help.
Ten patients came to the hospital after three to seven days of mild cough and fever. All of them suddenly fainted or had difficulty breathing.
“One of the things that people see with Covid now is a cytokine storm produced by the virus,” Vander Heide said. Cytokine storms are a flood of immune system compounds produced by several people in response to infection. “We can see it in parts of our lungs. We see the effect of viruses in cells,” he added.
The corona virus itself can cause effects, or affected patients may have their own predisposition to cytokine storms and blood clots, Vander Heide said. “There may be all kinds of genetic factors,” he added.
What pathologists don’t see is heart inflammation, a consequence of coronaviruses that doctors in China say they see in their patients.
They also saw no evidence of what was known as a secondary infection in patients. There are no bacteria or fungi that jump on the bandwagon to infect them.
“We also note that two of our patients aged 40-50 years, younger than those generally considered at risk of dying from Covid-19,” the researchers wrote.
This finding could explain why black people in general suffer more from Covid-19 in the UK, writes Dennis McGonagle of the University of Leeds and colleagues in related comments.
“A feature of the 2019 pandemic coronavirus disease has been an increase in deaths in Black, Asian and Ethnic Minority groups in the UK, which has resulted in the British Government forming an emergency investigation task force,” they wrote.
“In the US, the death rate from COVID-19 is very high in the African-American community in big cities.”
A study from New Orleans in Australia Journal of New England Medicine, also published on Wednesday, found a disproportionately number of Covid-19 hospital patients were African Americans. While 31% of the usual patient population in the Ochsner Health system is black, 77% of those treated for black coronavirus, the researchers report. And 70% of those who die are black.
“Black patients have a higher prevalence of obesity, diabetes, hypertension and chronic kidney disease than white patients,” Dr. Eboni Price-Haywood and her partner at Ochsner.
But many factors might underlie racial differences, they said.
“They may reflect fundamental racial differences in the types of jobs that might have an increased risk of community exposure (eg, service work),” they wrote. “The racial differences in Covid-19 observed may also reflect differences in the prevalence of chronic conditions that seem to increase the risk of severe disease.”
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