Effect of the COVID-19 Pandemic on Autopsy Rate

ABSTRACT

Background: Hospital autopsy rates have been steadily dropping over the past 50 years in the United States. It is unclear whether concerns of potential risks of exposure to SARS-CoV-2 through aerosols generated during dissection of lungs, infusion of formalin into lungs, and during opening skulls with an oscillating saw affect the overall autopsy rate. Design: Autopsy rate was calculated during a period from March 2019 to February 2020 (before COVID-19 pandemic in Rhode Island) and that from March 2020 to February 2021 (COVID-19 pandemic period). Death and autopsy numbers were also analyzed. Results: Autopsy rate over a year before the COVID-19 pandemic (between March 2019 and February 2020) was 8.4% (117/1391), whereas it was 9.1% (136/1492) during the COVID-19 pandemic (March 2020-February 2021). The difference was not statistically significant. During the COVID-19 pandemic between October 2020 and April 2021, the autopsy rate for non-COVID patients was 11%, whereas it was 8.6% in patients with COVID-19. The autopsy rate was slightly lower in COVID-19 patients, but the difference was not statistically significant. The death number and the percentage of death of patients with COVID-19 among all deaths reached a peak in December 2020, whereas the death number in non-COVID patients was relatively stable. The autopsy number also reached the peak in December 2020 and January 2021. From October 2020 to February 2021, the total autopsy number increased by 38-200%, when compared with one year ago (October 2019 to February 2020). The autopsy rate also increased from 7.9% before COVID-19 (from October 2019 to February 2020) to 10.7% during the same months of the COVID-19 pandemic, but the increase did not have the statistical significance. Conclusions: The COVID-19 pandemic did not affect the overall autopsy rate, but it increased the number of autopsy cases.