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Minimally invasive autopsy practice in COVID-19 cases
Biosafety and findings
Rakislova, N., Marimón, L., Ismail, M. R., Carrilho, C., Fernandes, F., Ferrando, M., Castillo, P., Rodrigo-Calvo, M. T., Guerrero, J., Ortiz, E., Muñoz-Beatove, A., Martinez, M. J., Hurtado, J. C., Navarro, M., Bassat, Q., Maixenchs, M., Delgado, V., Wallong, E., Aceituno, A., ... Ordi, J. (2021). Minimally invasive autopsy practice in COVID-19 cases: Biosafety and findings. Pathogens, 10(4), Article 412. https://doi.org/10.3390/pathogens10040412, https://doi.org/10.3390/pathogens10040412
Postmortem studies are crucial for providing insight into emergent diseases. However, a complete autopsy is frequently not feasible in highly transmissible diseases due to biohazard challenges. Minimally invasive autopsy (MIA) is a needle-based approach aimed at collecting samples of key organs without opening the body, which may be a valid alternative in these cases. We aimed to: (a) provide biosafety guidelines for conducting MIAs in COVID-19 cases, (b) compare the performance of MIA versus complete autopsy, and (c) evaluate the safety of the procedure. Between October and December 2020, MIAs were conducted in six deceased patients with PCR-confirmed COVID-19, in a basic autopsy room, with reinforced personal protective equipment. Samples from the lungs and key organs were successfully obtained in all cases. A complete autopsy was performed on the same body immediately after the MIA. The diagnoses of the MIA matched those of the complete autopsy. In four patients, COVID-19 was the main cause of death, being responsible for the different stages of diffuse alveolar damage. No COVID-19 infection was detected in the personnel performing the MIAs or complete autopsies. In conclusion, MIA might be a feasible, adequate and safe alternative for cause of death investigation in COVID-19 cases.
