Practical aspects of COVID-19 autopsies
- 1 March 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Der Pathologe
- Vol. 42 (2), 197-207
- https://doi.org/10.1007/s00292-021-00925-w
Abstract
Background. The COVID-19 pandemic represents a so far unknown challenge for the medical community. Autopsies are important for studying this disease, but their safety was challenged at the beginning of the pandemic. Objectives. To determine whether COVID-19 autopsies can be performed under existing legal conditions and which safety standards are required. Materials and methods. The autopsy procedure undertaken in five institutions in Germany, Austria, and Switzerland is detailed with respect to legal and safety standards. Results. In all institutions the autopsies were performed in technically feasible rooms. The personal equipment consisted of functional clothing including a disposable gown and apron, a surgical cap, eye protection, FFP-3 masks, and two pairs of gloves. In four institutions, complete autopsies were performed; in one institution the ultrasound-guided biopsy within the postmortal imaging and biopsy program. The latter does not allow the appreciation of gross organ pathology; however, it is able to retrieve standardized biopsies for diagnostic and research purposes. Several scientific articles in highly ranked journals resulted from these autopsies and allowed deep insights into organ damage and conclusions to better understand the pathomechanisms. Viral RNA was frequently detectable in the COVID-19 deceased, but the issue of infectivity remains unresolved and it is questionable if Ct values are greater than 30. Conclusions. With appropriate safeguards, autopsies of people who have died from COVID-19 can be performed safely and are highly relevant to medical research.This publication has 34 references indexed in Scilit:
- Pulmonary Arterial Thrombosis in COVID-19 With Fatal OutcomeAnnals of Internal Medicine, 2020
- Autopsy Findings and Venous Thromboembolism in Patients With COVID-19Annals of Internal Medicine, 2020
- COVID-19 Autopsies, Oklahoma, USAAmerican Journal of Clinical Pathology, 2020
- Postmortem examination of COVID‐19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings in lungs and other organs suggesting vascular dysfunctionHistopathology, 2020
- Endothelial cell infection and endotheliitis in COVID-19The Lancet, 2020
- Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in ChinaKidney International, 2020
- Autopsy in suspected COVID-19 casesJournal of Clinical Pathology, 2020
- Pulmonary Pathology of Early-Phase 2019 Novel Coronavirus (COVID-19) Pneumonia in Two Patients With Lung CancerJournal of Thoracic Oncology, 2020
- Ultrasound-guided minimally invasive autopsy as a tool for rapid post-mortem diagnosis in the 2018 Sao Paulo yellow fever epidemic: Correlation with conventional autopsyPLoS Neglected Tropical Diseases, 2019