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Lacy, J Matthew; Brooks, Erin G; Akers, Joshua; Armstrong, Danielle; Decker, Lauren; Gonzalez, Adam; Humphrey, William; Mayer, Romana; Miller, Matthew; Perez, Catherine; Arango, Jose Antonio Ruiz; Sathyavagiswaran, Lakshmanan; Stroh, Wendy; Utley, Suzanne
The American journal of forensic medicine and pathology, 2020-September, Volume: 41, Issue: 3Journal Article
ABSTRACTAs 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.
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