Coronavirus, “so it was defused.” From the autopsies the way to cure


Bergamo, 26 May 2020 – The smash is over. When the city of Bergamo was in the eye of the Cyclone Coronavirus, a doctor from Sondrio, Andrea Gianatti, 55 years old, graduated in Pavia, head of the pathological anatomy of the Papa Giovanni XXIII Hospital, started the first investigations on Covid, in the morgue. He went down to hell with his men for a heroic feat. He studied a hundreds of corpses, describing those thrombotic phenomena in the arteries of the lungs which then allowed clinicians to stop the massacre. Anticoagulants and anti-inflammatories (heparin and cortisone) administered at the right time at optimal doses have reversed the fate of the war. Gianatti was on the Piave line. Today the developments of the investigation are followed with interest all over the world, Italy has made school.

Doctor Gianatti, finished the new arrivals in intensive care?
“Indeed, the diagnostic findings related to the pandemic are running out. The latest deaths refer to a queue of long-term patients in the resuscitation”.

What has he been able to observe so far?
“The organ most involved is the lung, precisely because the virus, due to its own biological characteristics, returns histological alteration data which correspond to the pictures of acute respiratory insufficiency, frequent cause of death. In addition to the lungs, the virus rages on the heart, in cardiopathic subjects. The tendency to thromboembolism has been documented by large obstructions of the pulmonary artery, small occlusions scattered in peripheral veins and arteries. This virus also affects liver and kidney, in a less relevant way. As cause of death in Covid we have found thrombi also extended to the level of the right section of the heart “.

How did you approach the cure?
“This was the most engaging part, following the outbreak of the pandemic we realized that there were some missing pieces. In early March it was decided to study the pathological anatomy, then confronted in collegial meetings between specialists from all backgrounds during the peak between March and April. Hence the idea of ‚Äč‚Äčintervening on coagulation on an empirical level, with heparin, after seeing the thromboembolic picture, and using cortisone in the vascular inflammatory turn “.

Have you dealt with hospitals in other cities?
“We started almost in unison with the colleagues of the Sacco hospital in Milan, in order to gather the data of the first autopsies, we are waiting for the ok to be published by ‘The Lancet’, first author Luca Carsana, but the data are already available online “.

By examining all those infected specimens, you saved the lives of an incalculable number of people, and gave a coup de grace to the epidemic. Who made you risk your skin?
“You were supposed to be in Bergamo at the time, we seemed to be under a hurricane. It was crucial to understand why this cytokine storm started. The ultrasound machines struggle to visualize certain small lesions, which are visible only under a microscope, and the task was up to us”.

Has the case study been exhausted?
“In fact, yes, the influx into the mortuary has reduced a lot.”

The victims of these days are patients who had suffered permanent damage in the past few months. What are we facing?
“The epidemic from the anatomopathologist’s point of view is under control, better this way. We have had very different histologically different pictures. The disease maintains its characteristics, but now we don’t see any more serious cases.”

“We have isolated the virus, it is less strong.” Turn in the laboratory: here is the evidence

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