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Ruptured Heart Caused First COVID-19 Death in U.S., Autopsy States

A California woman who is thought to be the first person to die of COVID-19 in the U.S. suffered a ruptured heart, according to an autopsy report.

Patricia Dowd, 57, died on February 6, 2020, the report exclusively obtained by the San Francisco Chronicle stated.

The autopsy report signed by medical examiner Dr. Susan Parson said that Dowd complained of flu-like symptoms in the days leading up to her death. Dowd was described as “mildy obese” but had no known underlying conditions. The document showed that as well as her heart, COVID-19 had spread to her trachea, lungs, and intestines. Parson found evidence that Dowd’s left ventricle had ruptured, and this was linked to COVID-19.

Dr. Judy Melinek, who was not involved in the autopsy, told the San Francisco Chronicle Dowd‘s heart tore open because the muscle was infected by the coronavirus.

“There’s something abnormal about the fact that a perfectly normal heart has burst open,” she said. “The heart has ruptured. Normal hearts don’t rupture.”

Melinek told The Mercury News: “The immune system was attacking the virus and in attacking the virus, it damaged the heart and then the heart basically burst.”

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She said a rupture of this kind usually happens in people with high cholesterol or heart abnormalities, but Dowd‘s heart was normal.

However, Dr. Andrew Connolly, a pathologist at the University of California San Francisco who was not involved in the autopsy, told the San Francisco Chronicle that the virus or an immune reaction may have caused Dowd‘s heart to become inflamed.

It was previously thought that the first coronavirus death in the U.S. was on February 26 in Washington State, and in Santa Clara County on March 9.

According to the San Francisco Chronicle, the Santa Clara medical examiner’s office stored Dowd‘s tissue because she didn’t test positive for viral infections like the flu but it was not possible to screen it for COVID-19 when she died. The U.S. Centers for Disease Control and Prevention on Tuesday confirmed COVID-19 played a role in her death.

CBS SF Bay Area reported the medical examiner of Santa Clara County has reclassified nine deaths from flu to coronavirus in the past week, including Dowd‘s.

In a letter on Friday sent to the country Board of Supervisors, medical examiner Dr. Michelle Jorden said according to CBS: “Some cases are not yet closed and were not included in the current COVID-19 death count.”

Dowd is among the more than 3 million people worldwide to have been diagnosed with COVID-19. According to Johns Hopkins University, 211,326 have died, and 896,196 have recovered. New York is the U.S. state with the most confirmed COVID-19 cases, as shown in the Statista graph below, with California coming fifth.

A graph showing which U.S. states have the most coronavirus cases. Statista

Centers for Disease Control and Prevention Advice on Using Face Coverings to Slow Spread of COVID-19

  • CDC recommends wearing a cloth face covering in public where social distancing measures are difficult to maintain.
  • A simple cloth face covering can help slow the spread of the virus by those infected and by those who do not exhibit symptoms.
  • Cloth face coverings can be fashioned from household items. Guides are offered by the CDC. (https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html)
  • Cloth face coverings should be washed regularly. A washing machine will suffice.
  • Practice safe removal of face coverings by not touching eyes, nose, and mouth, and wash hands immediately after removing the covering.

World Health Organization advice for avoiding spread of coronavirus disease (COVID-19)

Hygiene advice

  • Clean hands frequently with soap and water, or alcohol-based hand rub.
  • Wash hands after coughing or sneezing; when caring for the sick; before, during and after food preparation; before eating; after using the toilet; when hands are visibly dirty; and after handling animals or waste.
  • Maintain at least 1 meter (3 feet) distance from anyone who is coughing or sneezing.
  • Avoid touching your hands, nose and mouth. Do not spit in public.
  • Cover your mouth and nose with a tissue or bent elbow when coughing or sneezing. Discard the tissue immediately and clean your hands.

Medical advice

  • Avoid close contact with others if you have any symptoms.
  • Stay at home if you feel unwell, even with mild symptoms such as headache and runny nose, to avoid potential spread of the disease to medical facilities and other people.
  • If you develop serious symptoms (fever, cough, difficulty breathing) seek medical care early and contact local health authorities in advance.
  • Note any recent contact with others and travel details to provide to authorities who can trace and prevent spread of the disease.
  • Stay up to date on COVID-19 developments issued by health authorities and follow their guidance.

Mask and glove usage

  • Healthy individuals only need to wear a mask if taking care of a sick person.
  • Wear a mask if you are coughing or sneezing.
  • Masks are effective when used in combination with frequent hand cleaning.
  • Do not touch the mask while wearing it. Clean hands if you touch the mask.
  • Learn how to properly put on, remove and dispose of masks. Clean hands after disposing of the mask.
  • Do not reuse single-use masks.
  • Regularly washing bare hands is more effective against catching COVID-19 than wearing rubber gloves.
  • The COVID-19 virus can still be picked up on rubber gloves and transmitted by touching your face.

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