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Autopsies of COVID-19 patients reveal surprising effects of heart damage
The information could influence future treatments.
- LSU Health New Orleans pathologists conducted autopsies on 22 patients that died of the novel coronavirus.
- The team discovered that damage is not typical inflammation of the heart, as is common with myocarditis.
- These research findings could have implications in treating COVID-19.
Science is not an infallible truth waiting to be discovered, but the process of acquiring knowledge through experimentation, observation, and confirmation. The fact that science—in the case of the novel coronavirus pandemic, medicine—is beholden to the whims of breaking news cycles sets us back. Medicine should be not be politicized, but we can't escape who we are.
We can become better, however, which is why the scientific process is valuable. A novel virus is just that: "new or unusual in an interesting way." COVID-19 is new, and while we've labeled it a respiratory virus, researchers recognize there's more going on. A lot more.
Take this new Research Letter on a series of 22 autopsies focused on heart damage caused by COVID-19. Conducted by LSU Health New Orleans pathologists and published in the journal, "Circulation," the researchers discovered that the heart damage is not typical inflammation, as is common with myocarditis.
Instead, the pathologists found a unique pattern of cell death in a number of heart muscle cells. This pattern differs from the first SARS coronavirus. Richard Vander Heide, professor and director of Pathology Research at LSU Health New Orleans School of Medicine and corresponding author of the Research Letter, says that while COVID-19 is similar to SARS in some ways, their findings reveal important distinctions that could affect future treatments.
Medical staff members wearing personal protective equipment (PPE) walks near a patient at Parque dos Atletas (Athlete's Village) field hospital amidst the coronavirus (COVID-19) pandemic on June 8, 2020 in Rio de Janeiro, Brazil.
Photo by Buda Mendes/Getty Images
An earlier report by the team found that patents suffered from diffuse alveolar damage, which affects "the small airspaces of the lung where gas exchange occurs." Blood clots and bleeding in blood vessels in the lungs, alongside severely enlarged right ventricles, were the major causes of death.
The age range of the patients was 44 to 79, with a median age of 68.5. Ten male and a dozen female patients were autopsied, 19 of whom were African-American. All suffered from pre-existing conditions: 18 had hypertension; nine were obese; half suffered from type 2 diabetes; and four had chronic kidney disease. While 18 of these patients were intubated, all died of respiratory failure.
The exact mechanism of cardiac injury from COVID-19 remains unknown. As the team writes in the Research Letter, these autopsies are providing insight into that process.
"Given that inflammatory cells can pass through the heart without being present in the tissue proper, a role for cytokine-induced endothelial damage cannot be ruled out."
Members of the LSU team are not the only researchers to discover viral infection of the endothelium, which might be the trigger for the cytokine storm.
Until the development of a vaccine, which may be some time off (and may never happen), or until more successful treatments are discovered, we'll have to settle for incremental knowledge. Like COVID-19 itself, the research process is not beholden to a news cycle, but we can be thankful for small gains in our understanding of this virus.
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The team caught a glimpse of a process that takes 18,000,000,000,000,000,000,000 years.
- In Italy, a team of scientists is using a highly sophisticated detector to hunt for dark matter.
- The team observed an ultra-rare particle interaction that reveals the half-life of a xenon-124 atom to be 18 sextillion years.
- The half-life of a process is how long it takes for half of the radioactive nuclei present in a sample to decay.
A study looks at the ingredients of a good scare.
Catching fear in a bottle<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDYyNzg1Ny9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyOTQwMTcyMn0.WtpJ1E_dhK2o09fBpKARynj4_p5NXeklgsXsbd7xr9w/img.jpg?width=980" id="8ff51" class="rm-shortcode" data-rm-shortcode-id="f10dd9188b173f4a36e85e9325507c6b" data-rm-shortcode-name="rebelmouse-image" />
Credit: Photo Boards/Unsplash<p>Previous studies have tracked physiological signs of fear arousal, but none have established a one-to-one correlation between that arousal and specific, actual fear events.</p><p>Andersen says that much of the research has been conducted in lab settings with weak fear stimuli, observing subjects as they experience things like scary videos. Scares in these situations tend to be weak and difficult to measure. Even harder to track in these situations is the link between enjoyment and fear. </p>
Eyes everywhere<iframe src="https://player.vimeo.com/video/109695164" width="100%" height="480" frameborder="0" scrolling="no" class="rm-shortcode" data-rm-shortcode-id="267ba87cfb8591ed5830499574d2272a"></iframe><p>Andersen and his colleagues conducted their experiments at <a href="https://dystopia.dk" target="_blank" rel="noopener noreferrer">Dystopia</a> Haunted House, a commercial attraction in Vejle, Denmark constructed in an old, run-down factory. The Recreational Fear Lab has a long-standing partnership with the spook shack.</p><p>They outfitted 100 volunteers with heart monitors and sent them on their terrifying way through the 50-room horror mansion. The facility incorporates a number of fright mechanisms including frequent jump scares in which a sudden threat takes a visitor by surprise.</p><p>Researchers surreptitiously observed their participants on closed-circuit video as they made their way through the attraction. They tracked each individual's scares, scoring them for intensity according to their visible reactions. After exiting the attraction, individuals self-reported their experiences in the haunted house.</p><p>Combining these self-reports with observer notes and each participant's heart-rate data gave the researchers subjective, behavioral, and physiological insights into the ways in which fear is experienced, and when it's a good thing or not.</p>
A pair of inverted U-shapes<p>In analyzing their data, the researchers saw two separate inverted u-shape curves. One depicted participants' enjoyment based on their self-reports and observed behavior. A similar u-curve was detected in their heart rates showing that just the right amount of heartbeat acceleration is associated with fun, but too much is too much. It's the terror Goldilocks zone.</p><p>Says Andersen, "If people are not very scared, they do not enjoy the attraction as much, and the same happens if they are too scared. Instead, it seems to be the case that a 'just-right' amount of fear is central for maximizing enjoyment."</p><p>The research suggests that being scared is enjoyable when it represents just a quick minor physiological deviation from one's normal state. When it goes on too long, however, or triggers too severe a physiological change, it becomes disturbing. Game over.</p><p>Andersen notes that this is not dissimilar to the factors known to make interpersonal play enjoyable: just the right amount of uncertainty and surprise. These are, maybe not coincidentally, also the ingredients of a successful joke.</p>
A meteorite that smashed into a frozen lake in Michigan may explain the origins of life on Earth, finds study.
- A new paper reveals a meteorite that crashed in Michigan in 2018 contained organic matter.
- The findings support the panspermia theory and could explain the origins of life on Earth.
- The organic compounds on the meteorite were well-preserved.
Meteor streaks through Michigan sky<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="80b7f30820153b35fc515592d7475f53"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/EPu2qnqMYBo?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
The meteorite that smashed into Strawberry Lake carried pristine extraterrestrial organic compounds.
Credit: Field Museum