Yadav Jayanthi, Patel Brinda, S Mahaluxmi, Js Sravan
Forensic Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Cureus. 2021 Oct 22;13(10):e18984. doi: 10.7759/cureus.18984. eCollection 2021 Oct.
Coronavirus disease 2019 (COVID-19) has besieged mankind because of its novelty, causing a global health crisis. The autopsy-based studies provide a crucial role in understanding the pathophysiology and the behavior of the disease. But there is a paucity of such studies in the world especially so from developing nations. Conducting a complete autopsy on infectious bodies like COVID-19 requires conducive infrastructural setup and protocols suited to the needs, and precautions are to be taken meticulously.
A complete pathological autopsy was conducted on a known case of a COVID-19-hospitalized patient, who died in our institution, with the aim to look for histopathological changes in each organ and to compare these findings with clinical findings such as duration of hospitalization, mechanical ventilation, comorbidities, biochemical parameters, and the result of real-time (RT-PCR) of the tissues. The complete autopsy was performed after obtaining consent from the family, and the study was approved by the Institutional Ethics Committee. Histopathological examination (HPE) and RT-PCR were conducted on the tissue collected during autopsy. Clinical and biomedical data were collected and correlated.
The written informed consent from the family could be obtained in only 15.3% of cases, which was a limiting factor. The post-mortem interval ranged from 3.5 to 19.5 hoursThe gross findings revealed pathologic features of viral infection as well as existing comorbidities in all the organs. The development of protocols and new innovations to limit the spread of infection, taking into consideration the limited facilities, which are described in this article, resulted in the successful completion of all the autopsies with a good sample collection, and nobody in the autopsy team was tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
The experience gained from these 21 COVID-19 autopsies helps to outline the basic or minimal requirements for conducting autopsies in highly infectious cases even in not-so-ideal conditions and also provides guidelines to be used while conducting such autopsies, especially in developing countries.
2019冠状病毒病（COVID-19）因其新颖性而困扰着人类，引发了全球健康危机。基于尸检的研究对于理解该疾病的病理生理学和发病机制起着至关重要的作用。但全球范围内此类研究匮乏，发展中国家尤为如此。对COVID-19这类传染性尸体进行完整尸检需要适宜的基础设施设置和符合需求的方案，且需谨慎采取预防措施。
对我院一名已知的COVID-19住院患者进行了完整的病理尸检，该患者在我院死亡，目的是寻找各器官的组织病理学变化，并将这些发现与临床结果进行比较，如住院时间、机械通气、合并症、生化参数以及组织的实时（RT-PCR）结果。在获得家属同意后进行了完整尸检，该研究获得了机构伦理委员会的批准。对尸检过程中采集的组织进行了组织病理学检查（HPE）和RT-PCR检测。收集并关联了临床和生物医学数据。
仅15.3%的病例获得了家属的书面知情同意，这是一个限制因素。尸检间隔时间为3.5至19.5小时。大体检查结果显示所有器官均有病毒感染的病理特征以及现有的合并症。考虑到设施有限，本文描述了为限制感染传播而制定的方案和新创新措施，这些措施使得所有尸检均成功完成，并采集到了良好的样本，尸检团队中无人检测出严重急性呼吸综合征冠状病毒2（SARS-CoV-2）呈阳性。
从这21例COVID-19尸检中获得的经验有助于勾勒出即使在不太理想的条件下对高传染性病例进行尸检的基本或最低要求，也为进行此类尸检提供了指导方针，尤其是在发展中国家。
