If you read the comments on any COVID-19 story you see on social media, you might notice the claims that health care workers aren't differentiating between people who have died from the virus and people who have died with the virus. A study conducted by a team of doctors, including two from the Cleveland Clinic, shows that it can, in fact, be determined if the virus was the immediate cause of the death or just a factor, and can be reported accordingly.
Dr. Subha Ghosh and Dr. Sanjay Mukhopadhyay from the Department of Pathology at the Cleveland Clinic worked alongside Dr. Lisa Barton, Dr. Eric Duval and Dr. Edana Stroberg to conduct autopsies on two individuals who had tested positive for COVID-19 and had died in Oklahoma.
The first case was a 77-year-old man who had high blood pressure, arthritis and other non-respiratory medical issues. Before his death, the man had experienced chills and fevers for six days but did not have a cough. EMS was called after the man reported weakness, fever, and shortness of breath. He went into cardiac arrest died shortly after arrival at the hospital, according to information in the study.
The second case was a 42-year-old man with a history of myotonic muscular dystrophy. He was admitted to the hospital in critical condition and died after going into cardiac arrest hours later, the study said.
An autopsy of both men was conducted by the doctors to determine the cause of death.
Nasal and lung tests of the 77-year-old man both came back positive for COVID-19. The lungs of the man showed diffuse alveolar damage, or damage to the walls of the air sacs in the lungs which help oxygenate blood cells. He had inflammation of the main passageway into the lungs, according to the study.
While the man showed signs of other underlying diseases, including heart disease, they were not advanced enough to have resulted in his immediate death—so the cause of death was listed as COVID-19 and coronary artery disease was listed under “other contributing factors,” the study said.
Nasal tests of the 42-year-old man also tested positive for COVID-19, but lung tests did not. Unlike the first case, the 42-year-old man did not have evidence of diffuse alveolar damage. A respiratory pathogen panel that detects viral and bacterial organisms associated with respiratory infection came back negative for COVID-19. After finding liver cirrhosis and other underlying medical issues, the cause of death was listed as complications of hepatic cirrhosis, according to the study.
What it means
The study, which is the first peer-reviewed study in the United States focused on autopsies of COVID-19 patients, showed that there is a way for the medical community to differentiate between patients who die from COVID-19 and patients who die with COVID-19.
In the first case, the man had other health conditions, but none that would have led to his immediate death and COVID-19 was the predominant factor. In the second case, the man had COVID-19, but his other heath conditions showed to be more prominent in his immediate death. There is a difference, the study showed.
So the rumors that doctors are just lazily marking COVID-19 as the cause of death for every patient they lose during the pandemic are just that—rumors. Medical professionals are working tirelessly to provide accurate data because accurate data helps to understand the virus and its effects. There is an extensive number of studies and amount of research being conducted around the country to learn more about the new novel coronavirus, including this one from the doctors of the Cleveland Clinic.
To read the entire study published in the American Journal of Clinical Pathology, click here.
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