Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 12, 27100, Pavia, Italy.
College of Pharmacy, California Northstate University, Elk Grove, CA, USA.
Forensic Sci Med Pathol. 2021 Jun;17(2):262-270. doi: 10.1007/s12024-021-00358-0. Epub 2021 Feb 13.
Italy and the United States are two of the countries most affected by SARS-CoV-2 (COVID-19), with more than 240,760 confirmed cases in Italy and 2,699,658 in the United States (as of July 2, 2020). The current COVID-19 pandemic has led to substantial changes in many fields of medicine, specifically in the forensic discipline. Medicolegal activities related to conducting autopsies have been largely affected by the COVID-19 pandemic. Postmortem examinations are generally discouraged by government regulations due to the risk of spreading the disease further through the handling and dissection of bodies from patients who succumbed to COVID-19 infection. There is a paucity of data regarding the persistence of SARS-CoV-2 in bodies, as well as concerning the reliability of swabbing methods in human remains. On the other hand, the autopsy is an essential tool to provide necessary information about the pathophysiology of the disease that presents useful clinical and epidemiological insights. On this basis, we aim to address issues concerning general medical examiner/coroner organization, comparing the Italian and American systems. We also discuss the pivotal roles of forensic pathologists in informing infectious disease surveillance. Finally, we focus on the impact of COVID-19 emergency on medicolegal practices in Italy and the United States, as well as the responses of the forensic scientific community to the emerging concerns related to the pandemic. We believe that stronger efforts by authorities are necessary to facilitate completing postmortem examinations, as data derived from such assessments are expected to be paramount to improving patient management and disease prevention.
意大利和美国是受 SARS-CoV-2（COVID-19）影响最严重的两个国家，意大利确诊病例超过 240760 例，美国超过 2699658 例（截至 2020 年 7 月 2 日）。当前的 COVID-19 大流行导致医学的许多领域发生了重大变化，特别是法医学科。与进行尸检相关的法医活动受到 COVID-19 大流行的极大影响。由于担心通过处理和解剖 COVID-19 感染死亡患者的尸体进一步传播疾病，政府法规普遍不鼓励进行尸检。关于 SARS-CoV-2 在尸体中的持续存在以及在人类遗骸中使用拭子检测方法的可靠性方面的数据很少。另一方面，尸检是提供有关疾病病理生理学的必要信息的重要工具，这些信息为临床和流行病学提供了有用的见解。在此基础上，我们旨在解决一般法医检查官/验尸官组织的问题，比较意大利和美国的系统。我们还讨论了法医病理学家在传染病监测方面的关键作用。最后，我们关注 COVID-19 紧急情况对意大利和美国的法医实践的影响，以及法医科学界对与大流行相关的新出现问题的反应。我们认为，当局有必要加大力度促进完成尸检，因为此类评估得出的数据有望对改善患者管理和疾病预防至关重要。
