And what makes the difference between before and after is the sudden formation of a thrombus, a blood clot on the atherosclerotic plaque that ends up closing the artery completely. Atherosclerotic plaques are not a simple thickening of the internal walls of the vessels, they are 'living' structures that go through phases of 'activation', during which they become unstable and therefore at risk of thrombosis, and phases of 'healing'. In the last thirty years, research has focused mainly on the mechanisms that make a plaque unstable, but these have not allowed us to identify biomarkers capable of anticipating the 'big one', i.e. heart attack or sudden death. If these 'mountains' grow in the coronary arteries (the vessels that bring oxygen and nourishment to the heart muscle) and exceed a certain height, they limit the increase in blood flow that the heart needs when making an effort». This 'volcano' is much more dangerous than the mountains because it can cause a heart attack or sudden death», says Professor Crea. However, not all atherosclerotic plaques are destined to cause a heart attack, i.e. to become a 'volcano'. We have discovered that 'eruptions' of atherosclerotic plaque mountains are very frequent, but fortunately many of them do not give symptoms because the body reacts by 'extinguishing' the volcano, i.e. healing the plaque and preventing the formation of thrombosis.
Research Testing positive for Coronavirus does not mean being contagious A study conducted by researchers of the Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica has been published in JAMA Internal Medicine. The detection of the so-called viral replicative RNA is proposed by the authors as an indicator of the presence of vital and potentially transmissible viruses, but further studies will be needed to establish whether these patients can actually transmit the virus. During the follow-up (approximately 50 days after the diagnosis of COVID-19), the nasal-oropharyngeal samples of these patients were tested for the presence of both total (genomic) and replicative (subgenomic) viral RNA. «The presence of replicative RNAs in the samples was used as an indicator of ongoing viral replication. Only one of these, however, also tested positive for SARS CoV-2 replicative RNA. Samples obtained from patients at the time of the disease were reanalysed and, as expected, all tested positive for SARS CoV-2 replicative RNA», said Professor Sanguinetti. The only patient who tested positive for both total and replicative RNA became positive 16 days after recovery (and 39 days after the initial diagnosis of COVID-19) was an elderly patient with hypertension, diabetes and cardiovascular disease, who had a symptomatology compatible with COVID-19 at follow-up.“ This study confirms the usefulness of performing an accurate follow-up of recovered COVID-19 patients and reinforces the concept that reinfections in recovered COVID-19 patients are rare ‒ concluded Sanguinetti ‒although testing positive to the ‘conventional’ molecular test (which detects total SARS CoV-2 RNA). Therefore, research into SARS CoV-2 replicating RNA could help resolve the dilemma about the real infectivity of recovered COVID-19 patients who return positive for SARS CoV-2 RNA».