A technical report from the Italian SARS-CoV-2 outbreak. Postmortem sampling and autopsy investigation in cases of suspected or probable COVID-19

Forensic Sci Med Pathol. 2020 Sep;16(3):471-476. doi: 10.1007/s12024-020-00258-9. Epub 2020 May 12.

Abstract

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is a coronavirus responsible for COVID-19 (coronavirus disease 2019) which resulted in a cluster of cases of pneumonia that originated in China around 31 December 2019 and has subsequently spread across the globe. Currently, COVID-19 represents a health emergency worldwide, leading, in severe cases, to pneumonia, severe acute respiratory syndrome, multiorgan dysfunction or failure, and death. In the context of limited scientific knowledge and evidence of SARS-CoV-2 infection, guidance is becoming increasingly necessary for pathologists who have to perform postmortem investigations on COVID-19 cases. The aim of the present report is to share a procedure applicable to cases of COVID-19-related death, particularly in cases of death without medical intervention and in the absence of an ascertained SARS-CoV-2 infection and/or COVID-19 diagnosis, therefore providing support for diagnostic activity in the present COVID-19 pandemic. For this purpose, a standard operating procedure for correct swab collection, autopsy investigation and tissue sampling is provided.

Keywords: Autopsy investigation; COVID-19; Postmortem diagnosis; SARS-CoV-2; Virological diagnosis.

MeSH terms

  • Autopsy
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • Cause of Death
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / pathology
  • Coronavirus Infections / virology
  • Forensic Sciences / standards*
  • Host Microbial Interactions
  • Humans
  • Italy
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / pathology
  • Pneumonia, Viral / virology
  • Predictive Value of Tests
  • Respiratory System / pathology
  • Respiratory System / virology*
  • SARS-CoV-2
  • Specimen Handling / standards*
  • Virology / standards*