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She was one of the first to perform autopsies on patients who died with Covid-19 in March. Since then, Kirsten Mertz, chief physician in the pathology department at Baselland Cantonal Hospital, has examined several dozen lungs for corona deaths with her team. The results were published in a study this week. Mertz’s findings pave the way for a more tailored and specific therapy for corona patients. With the number of cases rising rapidly, growing nervousness in the healthcare system, and a vaccine still lacking, this is more important than ever.
Ms. Mertz, as a pathologist, examined the affected lungs of deceased Covid 19 patients. What did you discover?
Two groups of patients can be identified. The first group dies at an early stage due to an enormously high viral load in the lungs. Unfortunately, the immune system is unable to suppress the virus. In the second group, however, it looks completely different: the body of these patients can initially defeat the virus, but then massive damage to the lungs and other organs can be seen. These patients only die after several days or weeks.
Why do these people die?
Even if these patients survive the acute virus attack phase, severe inflammation develops in the tissue as a result. Because the body reacts too violently to the intruder. The virus may go away, but the inflammation destroys tissue and organs. This can be as deadly as the virus itself.
Inflammation is part of the body’s immune response. How is it that the body itself becomes so dangerous for the patient?
The virus infects the cells of the lungs and hides in them. The infected cells are destroyed by the immune system. This kills the virus, but unfortunately also breaks down cells. It’s like when the dentist removes all of your teeth because you have cavities. Then the tooth decay disappears, but so do the teeth.
His study, which he published this week, is titled “Molecular Profile of a Killer.” Is the coronavirus still the same killer as it was in the spring when we were all shocked?
The coronavirus was and is a killer. This will also be the case in the future. There were slight mutations, but overall the virus itself hasn’t changed much. The risk groups remain the same, especially the elderly and people with previous illnesses. But no one has a guarantee that they will be saved from serious illness. After all, our knowledge of it has changed and improved rapidly.
How can your test results help us?
We already have medicines and we know better than half a year ago what works and what doesn’t. With the two groups that we found in our study, those who die earlier and those who die later, we can now better assess which drugs work best at what time. That is very helpful. For example, remdesivir, the antiviral drug that Donald Trump received, is sure to work better if given well in advance.
What does a serious illness currently depend on?
Safe from the dose. If you only get a small amount of the virus, you usually have fewer symptoms and don’t even have to go to the hospital. This is why masks and distance and hygiene measurements are so useful! They don’t protect us 100 percent from infections. But they definitely ensure that we catch fewer viruses. And with fewer viruses, severe illness becomes less likely.
The current high number of infections and low mortality rates would support this assumption.
Exactly, we have many infections, but fewer deaths than in spring. But we will only be able to say in a few weeks how the situation will develop. Because in addition to viral load, your own health and the constitution of the immune system also play a role. And it works differently for each and every one of us.
If better treatments at the right time can make a big difference, do we still need a vaccine?
Vaccination is by no means superfluous, since the immune system immediately intercepts the virus in vaccinated people. We have to hold out until we have effective vaccine protection. Unfortunately, no one knows when. We have a difficult winter half year ahead. We have to save this time with the most comprehensive therapeutic means possible and constantly adhering to protective measures. We have already accomplished a lot on this path.
