The autopsies comprised 9 male patients and 3 female patients, with a median age of 73. All of them had underlying health conditions, including heart disease and diabetes, and they all exhibited elevated levels of D-dimer, LDH and CRP, which are nonspecific markers of inflammation.
In each autopsy, medical staff looked at viral RNA; all 12 patients had the SARS-COV-2 RNA in their lungs, while 9 had it in their throats, and 6 had it in their bloodstream. 6 also had high levels of the RNA in the tissue of other organs including the heart, liver, kidney, and brain.
"It tells us that the virus is binding to those H2 receptors in those organs, so in some people who die of COVID, they had the virus in other organs besides the lungs," says Hansen. "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."
An important takeaway from this, he adds, is that while all 12 patient had the RNA in their lungs, only 9 had it in their throats. "So when you go to do a throat swab of somebody who has COVID, the virus might not even be there, and that's just another reason why you can get a false negative test," he says.
Hansen also acknowledges that blood clots , which many COVID patients experience, were present. Massive pulmonary embolisms (blood clots in the pulmonary arteries) were cause of death for 4. Additionally, 3 patients blood clots in their legs, and 6 of the 9 men had clots in the veins surrounding the prostate gland.
"Most people who die of COVID, it's primarily a lung problem either related to inflammation with ARDS and/or blood clots," he says. "Even though blood thinners are not a cure for COVID 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 low prophylactic doses?"
He adds that it is often difficult to diagnose blood clots in hospitalized patients, as finding clots in the lungs requires a CT angio scan, which uses larger doses of radiation. This also means moving a patient, which risks spreading the virus.
So should all severe COVID patients be on blood thinners? What about moderate patients? Should the general population be taking aspirin to lower their risk of clots should they contract the virus? The short answer, Hansen says, is simply: we don't know yet. "Not only do we need to know if there's a benefit in doing so, we have to know these benefits will outweigh the risks," he says.
However, there are preventative measures that everybody can be taking, he says, such as exercise, eating healthy, getting plenty of sleep, avoiding stress, not smoking, and proactively managing any existing medical conditions you may have.