both COVID 19 and influenza can cause pneumonia and ARDS which is acute respiratory distress
syndrome both of these can cause respiratory failure and death we know that covid is more
likely to cause severe disease compared to influenza and has a higher case fatality
rate we also know that kovat is much more likely to cause blood clots compared to influenza and
this recent study published in the New England Journal Medicine they actually compared long
autopsy findings from the ceased patients of covid and influenza and to compare these to the findings
of people who died of other causes who had normal lungs this group with the normal lungs served as
the control group so pneumonia is a very broad medical term that refers to inflammation within
parts of the lung or parts of both lungs this entails the tiny air sacs of the lungs called
alveoli to fill up with inflammatory fluid which impairs the flow of oxygen from the air to the
bloodstream the consequences of pneumonia whether caused by Covid 19 or influenza can result in
dangerously low oxygen levels in the bloodstream and if not treated can result in death sometimes
if pneumonia is severe enough it can cause Aird yes which refers to severe inflammation
within both lungs which causes extreme difficulty with getting oxygen into the blood this is a well
known syndrome that can occur with either covid or influenza pneumonia so SARS coronavirus - inflicts
a particular type of damage in human lungs that is somewhat different from the picture that we
see with influenza to understand the differences researchers in this study looked at the lungs of
seven patients who died a respiratory failure from Covid 19 and then compared those to the lungs of
seven patients who died of pneumonia that was caused by influenza A they also compared them
to the lungs of ten uninfected lungs which came from people whose organs had been donated for
transplant but were not used so these were normal lungs this was the control group the researchers
were careful to match as well as they could the gender and age of the patients so their
comparisons among the groups of patients would be meaningful all the lungs came from patients who
were older and whose average age in the Covid 19 group range from 68 years old for females
in 84 males average age in influenza group was 62 for females and 55 for males for the normal
lung group the average age of females was 68 and for the males it was 79 so the three groups were
fairly evenly matched in terms of age and each group was composed of both men and women there
was an interesting difference in actual weight of the lungs in the three different groups with the
average weight of the lungs for patients with influenza pneumonia being significantly higher
than those of the lungs from those of the covid 19 onea the reason behind this difference in lung
weight is probably due to the different pattern of infection in influenza pneumonia which I'll
get to in a little bit the normal lungs had an average weight that was lower than those
of either of the covid group or the influenza group and on further microscopic exam the lungs
of the patients with covid in the lungs of the patients with influenza showed a common pattern
they both had widespread damage to the alveoli the researchers also saw that in both kovat an
influenza groups they had the presence of lymphocytes which is a type of white blood
cell and these lymphocytes congregated around the small blood vessels that supply the alveoli
of lung capillaries white blood cells are one of the body's main types of immune cells and
are mobilized in the presence of an infection in addition the lung is infected with influenza virus
had massive fluid accumulation meaning edema around the lungs as well as deposits of fibrin
which is a protein involved in blood clotting together this edema and deposits of fibrin
account for the increased weight of lung tissue in influenza patient samples I mentioned earlier
in this video and that's not to say that the Covid group didn't have these findings it just wasn't
as much compared to influenza but perhaps the most interesting and important finding of this research
revealed damage to the lung capillaries the lining of these capillaries is called the endothelium and
the cells that make up the endothelium have h2 receptors on them the cells were in fact
infected with stars coronavirus - the researchers in this study found severe microscopic injuries
to the endothelium here with actual disruptions of the cell membranes they also found widespread
clotting these lung capillaries surrounding the alveoli which included actual blockage
of the capillaries and micro angiopathy which involves thickening and weakening of the small
blood vessel walls which begin to leak blood and protein further slowing the flow of blood through
these capillaries although fibrin clots in these lung capillaries were in both the Kovach group and
influenza group there are dying times as prevalent in the Covid group compared to influenza what's
more is that in the COBIT group they actually had new blood vessel growth primarily through
a process known as into susceptible genesis say what let's break that down to what that
means the word angiogenesis means the formation of new blood vessels the term intercepted refers
to something telescoping inside of itself in this context it's referring to new blood vessels being
formed by a pillar of tissue within another blood vessel effectively splitting that vessel into so
if you imagine a blood vessel is running this way so for me to you and you're looking down
the pipe of that blood vessel what's going on is that from that inside there's actually new blood
vessel forming and go into different parts of the vessel so it's like going from here to here or it
could be going from here maybe down to here something like that so if you look at it from
a 3d perspective it's actually form a new blood vessel inside other blood vessels the researchers
believe that this process contributes to more problems with clotting and inflammation of the
lining of the blood vessels compared to that of influenza so angiogenesis was much more prevalent
in the Covid group compared to the influenza group and there wasn't any angiogenesis at all in the
control group the researchers also looked at the ACE 2 receptor which is what allows the
SARS coronavirus to virus to gain entry into the cells compared to the lungs of the control group
there are more ace 2 positive cells in the lungs of both covid and influenza patients the Covid 19
group had the highest number of h2 positive cells in the endothelial cells followed by the influenza
group the control group had the least amount of h2 positive cells now the researchers in this
study speculated the reason for more angiogenesis in the covid is because of the evidence of viral
invasion of the endothelial cells because of that HT receptor being more prevalent there
also endothelial cells in the Covid group showed cellular swelling and disruption of the junctions
in between cells now as with all scientific research there are limitations to an individual
study for example in this case the sample size of just seven patients in each group is a limitation
also the influenza patients in this group were further along in their disease course compared
to the Covid group so that may or may not have an impact on these results clearly more research
is needed but this study demonstrates some similarities as well as clear differences in
the pathological findings and lungs of patients who have died of covid pneumonia versus influenza
pneumonia the evidence so far is showing us that covid not only has the potential to cause
widespread inflammation within the lungs but also it drastically affects the blood vessels within
our lungs and that includes the high potential for developing blood clots this is consistent with a
lot of the other studies that we've seen already and something that I've talked a lot about already
in my other videos so to see more of my videos click on that subscribe button click on that Bell
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