Governmental laws and regulations played an important role in mobilizing a rapid response to this major public-health emergency. “Commonly observed long-term psychological effects of ICU stays include anxiety, depression, and post-traumatic stress disorder (PTSD). 2).
In addition, the hyperplasia of pulmonary epithelial cells and the elevation of plasma carcinoembryonic antigen in some patients also require studies on the cause and follow-up. However, medical experts say the findings highlight the need to investigate the possible effects of Covid-19 in the brain and studies to explore potential treatments. In early June, a research team in France reported that 84 percent (49/58) of patients (median age 63 years) in intensive care for SARS-CoV-2 infection showed wide-ranging neurological symptoms that included increased agitation and confusion, poorly organized movement in response to commands, and corticospinal tract signs that included increased reflexes (think uncontrolled knee-jerk response), and flexion—particularly in patients' feet. In fact, COVID infection is a risk factor for strokes,” Budson stated. Indeed, in addition to hallmark symptoms like a fever, cough, and shortness of breath, Covid-19 can generate a wide range of symptoms, some more rare than others, including loss of smell and taste, altered brain function, heart problems, kidney damage, rashes, swollen toes, pink eye, vomiting, and diarrhea. After years of nationwide cuts, Massachusetts General is one of a limited number of hospitals left in the U.S. that has its own dedicated autopsy suite. Brain hyperemia and edema, partial neuron degeneration and ischemic changes were detected. Pulmonary vessels showed vasculitis, thrombosis (mixed thrombi and hyaline thrombi) and thromboembolism. “Particularly worrisome is that several of the patients who were autopsied did not show any signs of brain injury during the course of their COVID-19 infection — yet all had brain damage.
These efforts have strongly supported accuracy in diagnosis and treatment [1–4], and thus have significantly contributed to victory over the COVID-19 pandemic. Recent policy changes threaten to push the number of autopsies even lower: In 2019, the Centers for Medicare and Medicaid Services (CMS), under pressure from President Donald J. Trump’s administration to cut regulations, removed a requirement that hospitals attempt to secure an autopsy in cases where deaths were unusual or could serve an educational purpose like teaching physicians about how a particular disease kills patients. We also thank clinical staff and technicians for performing the autopsy work. Under electron microscopy, coronavirus particles were observed in the cytoplasm of tracheal and bronchial mucosa epithelia and alveolar type II pneumocytes. The more we learn, the broader the implications appear. COVID-19 has proven in some ways to be as mystifying to pathologists examining the dead as to physicians treating living patients. “I don’t think that CMS really recognizes what they’ve done,” says Victor Weedn, a forensic pathologist at The George Washington University.
For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Of the 125 cases reported in detail, the most common brain complication observed was stroke, which was reported in 77 patients. “We observed substantial yet highly variable degrees of astrogliosis in all assessed regions,” Glatzel and co-authors noted. But “our ability to determine the cause of death is pretty bad unless you do an autopsy,” says Mary Fowkes, a pathologist at Mount Sinai Hospital in New York. Effects due to COVID ICU stays are expected to be similar — a prediction that has already been confirmed by the studies in Britain, Canada, and Finland reviewed above,” he added. Psychology Today © 2020 Sussex Publishers, LLC, Obsessive-Compulsive Disorder: Research Update, How Spirituality, Wisdom, and Mental Health Are Intertwined, New Research Shows Why Your Decision-Making Could Be Flawed, AI Could Help Predict Alzheimer’s Disease Early Using Language, New Evidence That Spaceflight Changes Astronaut Brains, COVID-19 Is Not Just a Respiratory Illness, The Neurological Impact of Testing Positive for COVID-19, Novel COVID-19 Test Uses CRISPR Technology, Israeli Scientists Use AI to Detect COVID-19 Clusters, Neurological Implications of COVID-19 Raise Concerns, MIT Spinout Creates Rapid COVID-19 Diagnostic Test. While sometimes the brain damage is obvious and leads to major cognitive impairment, more frequently the damage is mild, leading to difficulties with sustained attention.
Sometimes families also find comfort in learning about their loved ones’ final days. In some deceased cases, nasopharyngeal swab test showed negative viral nucleic acid, but positive in other organs , suggesting that the current standard swab test for SARS-CoV-2 as an indicator for clinical cure and hospital discharge may not be adequate. COVID-19 only detected after blood sample tested positive postmortem --Source Families reluctant to consent to autopsies for their loved ones may be reassured that no facial procedures are involved. Those benefits could seem especially important with the onset of Covid-19 — a novel illness with effects on the body that scientists and physicians are still scrambling to understand. These issues merit further investigation. It's not just lungs: Covid-19 may damage the heart, brain, and kidneys
As of 22 April 2020, the COVID-19 Pathology Team has performed systematic autopsies on 37 COVID-19 cases. Under light microscopy, the parenchymal areas contained diffuse alveolar damage and exudative inflammation.