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Am J Forensic Med Pathol ; 41(3): 143-151, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-215983

ABSTRACT

As a result of the 2019 novel human coronavirus (COVID-19) global spread, medical examiner/coroner offices will inevitably encounter increased numbers of COVID-19-infected decedents at autopsy. While in some cases a history of fever and/or respiratory distress (eg, cough or shortness of breath) may suggest the diagnosis, epidemiologic studies indicate that the majority of individuals infected with COVID-19 develop mild to no symptoms. Those dying with-but not of-COVID-19 may still be infectious, however. While multiple guidelines have been issued regarding autopsy protocol in cases of suspected COVID-19 deaths, there is some variability in the recommendations. Additionally, limited recommendations to date have been issued regarding scene investigative protocol, and there is a paucity of publications characterizing COVID-19 postmortem gross and histologic findings. A case of sudden unexpected death due to COVID-19 is presented as a means of illustrating common autopsy findings, as well as diagnostic and biosafety considerations. We also review and summarize the current COVID-19 literature in an effort to provide practical evidence-based biosafety guidance for medical examiner-coroner offices encountering COVID-19 at autopsy.


Subject(s)
Autopsy/standards , Betacoronavirus/isolation & purification , Containment of Biohazards/standards , Coronavirus Infections/mortality , Coronavirus Infections/pathology , Pneumonia, Viral/mortality , Pneumonia, Viral/pathology , Betacoronavirus/genetics , Centers for Disease Control and Prevention, U.S. , Female , Humans , Middle Aged , Mortuary Practice/methods , Mortuary Practice/standards , Pandemics , Real-Time Polymerase Chain Reaction/standards , Triage , United States
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