Medical x-rays such as CT scans can provide a view of an entire organ, but they weren’t high-resolution enough. If just one percent of these blood vessels gets attacked by a virus, he adds, the blood’s flow and ability to absorb oxygen can be impaired, with potentially devastating consequences across entire organs.Īs soon as they recognized COVID-19’s vascular effects, Jonigk and Ackermann realized that they needed a much better view of the damage. “If you go through the human body and you take all the blood vessels in one line, you come up with to 70,000 miles, double the distance around the Equator,” says Ackermann, who is also a pathologist at Wuppertal, Germany’s HELIO Clinics. These landmark results, published online in May 2020, showed that COVID-19 wasn’t strictly a respiratory disease but a vascular one-one that could affect organs across the entire body. They immediately saw that among COVID-19 victims, the smallest blood vessels in the lungs were distorted and reshaped. Using this technique, Ackermann and Jonigk compared the tissues of people who hadn’t died of COVID-19 with those who had. They soon tested their blood-vessel hypothesis by injecting tissue samples with resin and then dissolving the tissues in acid, which left behind faithful casts of the original vasculature. As the disease spread through Germany in March 2020, the duo began conducting autopsies of COVID-19 victims. The two were especially concerned about reports of a “silent hypoxia” that left COVID-19 patients awake but caused their blood oxygen levels to plummet.Īckermann and Jonigk suspected that SARS-CoV-2 was somehow attacking the lungs’ blood vessels. Both had expertise in lung disease, and right away they knew COVID-19 was unusual. The HiP-CT technique got its start as two German pathologists raced to track the SARS-CoV-2 virus’s punishing effects across the human body.Īs soon as news of unusual pneumonia cases began trickling out of China, Danny Jonigk-a thoracic diseases pathologist at Hannover Medical School-and Maximilian Ackermann, a pathologist at University Medical Center Mainz, were on high alert. “What is perhaps a surprise to most people is we’ve been studying the heart anatomically since hundreds of years ago,” says UCL cardiac anatomist Andrew Cook, “but there isn’t a consensus about the normal structure of the heart, particularly the muscle cells, and how it changes as the heart beats.”Ī technique with HiP-CT’s promise, he says, is something “I’ve been waiting for my whole career.” And while its long-term promise is hard to define, because nothing quite like HiP-CT has ever existed before, researchers excited by its potential are enthusiastically dreaming up new ways to understand disease and more rigorously chart the terrains of human anatomy. The technique is already providing fresh insights into how COVID-19 damages and reshapes the blood vessels of the lungs. With it, they can finally go from a complete human organ to a zoomed-in view of the body’s tiniest blood vessels and even individual cells. Tafforeau and Walsh are part of an international team of more than 30 researchers that has created a powerful new kind of x-ray scan called hierarchical phase-contrast tomography (HiP-CT). “For the first time, we can make the real thing.” “In anatomy textbooks, when you see, This is the large scale, and this is the smaller one, they’re all beautiful hand-drawn images for a reason: They’re artistic interpretations, because we have no images for it,” says Claire Walsh, a senior postdoctoral fellow at University College London (UCL). The images presented them with richer detail than any medical CT scan they’d seen before, allowing them to bridge a stubborn gap in how scientists and doctors can visualize-and make sense of-human organs.
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