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Article: Autopsy in the time of COVID.

Griffin, Kathryn J

Diagnostic histopathology (Oxford, England)

2021 Volume 27, Issue 3, Page(s) 134–137

Abstract: ... of a COVID-19 autopsy performed at the start of the first phase of the pandemic and highlights some important ... limited knowledge of the autopsy findings following death from SARS-CoV-2 infection. The practicalities ... learning points for trainees engaged in autopsy practice. ...

Abstract	Whilst much literature has been published since the start of the COVID-19 pandemic, there remains limited knowledge of the autopsy findings following death from SARS-CoV-2 infection. The practicalities of triaging and examining bodies with suspected COVID-19 are complex and the need for full post-mortem must be balanced with the potential risks to mortuary staff. This brief case report describes the features of a COVID-19 autopsy performed at the start of the first phase of the pandemic and highlights some important learning points for trainees engaged in autopsy practice.
Language	English
Publishing date	2021-01-07
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2399849-0
ISSN	1756-2317
ISSN	1756-2317
DOI	10.1016/j.mpdhp.2020.12.002
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Article: The hospital autopsy: the importance in keeping autopsy an option.

Scarl, Rachel / Parkinson, Bryce / Arole, Vidya / Hardy, Tanner / Allenby, Patricia

Autopsy & case reports

2022 Volume 12, Page(s) e2021333

Abstract: ... essential to patient care through discussion of autopsy with families. At the same time, we analyzed ... at the time of death, and what may be the reasons for not wanting an autopsy. Our results showed a doubling ... of Coronavirus 2019 (COVID-19) has re-established the value of autopsy, as seen by increased autopsy rates ...

Abstract	Autopsy has been one of the most powerful diagnostic tools in medicine for over a century. Despite its importance in establishing cause of death and elucidating pathophysiology of disease, rates of hospital autopsies continue to decline. In this study we aim to determine if physicians believe autopsies are essential to patient care through discussion of autopsy with families. At the same time, we analyzed whether families are more willing to consent to autopsy if physicians are involved in autopsy discussion at the time of death, and what may be the reasons for not wanting an autopsy. Our results showed a doubling in autopsy consent when autopsy was discussed by the physician. Additionally, the biggest reason for families not consenting to autopsy was because they believed they already knew what caused death. The emergence of Coronavirus 2019 (COVID-19) has re-established the value of autopsy, as seen by increased autopsy rates in the past year. This study demonstrates that physician conversation with families on autopsy leads to an increased chance of autopsy consent.
Language	English
Publishing date	2022-02-17
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2815488-5
ISSN	2236-1960
ISSN	2236-1960
DOI	10.4322/acr.2021.333
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Article ; Online: Virtual histological staining of unlabeled autopsy tissue.

Li, Yuzhu / Pillar, Nir / Li, Jingxi / Liu, Tairan / Wu, Di / Sun, Songyu / Ma, Guangdong / de Haan, Kevin / Huang, Luzhe / Zhang, Yijie / Hamidi, Sepehr / Urisman, Anatoly / Keidar Haran, Tal / Wallace, William Dean / Zuckerman, Jonathan E / Ozcan, Aydogan

Nature communications

2024 Volume 15, Issue 1, Page(s) 1684

Abstract: ... extracellular features in new autopsy tissue samples that experienced severe autolysis, such as COVID-19 samples ... covering large tissue areas demand substantial labor, cost and time. Here, we demonstrate virtual staining ... of autopsy tissue using a trained neural network to rapidly transform autofluorescence images of label-free ...

Abstract	Traditional histochemical staining of post-mortem samples often confronts inferior staining quality due to autolysis caused by delayed fixation of cadaver tissue, and such chemical staining procedures covering large tissue areas demand substantial labor, cost and time. Here, we demonstrate virtual staining of autopsy tissue using a trained neural network to rapidly transform autofluorescence images of label-free autopsy tissue sections into brightfield equivalent images, matching hematoxylin and eosin (H&E) stained versions of the same samples. The trained model can effectively accentuate nuclear, cytoplasmic and extracellular features in new autopsy tissue samples that experienced severe autolysis, such as COVID-19 samples never seen before, where the traditional histochemical staining fails to provide consistent staining quality. This virtual autopsy staining technique provides a rapid and resource-efficient solution to generate artifact-free H&E stains despite severe autolysis and cell death, also reducing labor, cost and infrastructure requirements associated with the standard histochemical staining.
MeSH term(s)	Hematoxylin ; Eosine Yellowish-(YS) ; Staining and Labeling ; Neural Networks, Computer
Chemical Substances	Hematoxylin (YKM8PY2Z55) ; Eosine Yellowish-(YS) (TDQ283MPCW)
Language	English
Publishing date	2024-02-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-024-46077-2
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Article ; Online: The hospital autopsy

Rachel Scarl / Bryce Parkinson / Vidya Arole / Tanner Hardy / Patricia Allenby

Autopsy and Case Reports, Vol

the importance in keeping autopsy an option

2022 Volume 12

Abstract	Autopsy has been one of the most powerful diagnostic tools in medicine for over a century. Despite its importance in establishing cause of death and elucidating pathophysiology of disease, rates of hospital autopsies continue to decline. In this study we aim to determine if physicians believe autopsies are essential to patient care through discussion of autopsy with families. At the same time, we analyzed whether families are more willing to consent to autopsy if physicians are involved in autopsy discussion at the time of death, and what may be the reasons for not wanting an autopsy. Our results showed a doubling in autopsy consent when autopsy was discussed by the physician. Additionally, the biggest reason for families not consenting to autopsy was because they believed they already knew what caused death. The emergence of Coronavirus 2019 (COVID-19) has re-established the value of autopsy, as seen by increased autopsy rates in the past year. This study demonstrates that physician conversation with families on autopsy leads to an increased chance of autopsy consent.
Keywords	Autopsy ; COVID-19 ; SARS-CoV-2 ; Medicine ; R ; Internal medicine ; RC31-1245
Subject code	610
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	University of São Paulo
Document type	Article ; Online
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Article ; Online: What else in times of COVID-19? The role of minimally invasive autopsy for the differential diagnosis of acute respiratory failure in a case of kala-azar.

Geber Júnior, João Carlos / Monteiro, Renata Aparecida de Almeida / Rocha, João Wilson Pedro da / Duarte, Edson Luiz Társia / Nicodemo, Elizabete / Munhoz, Olavo / Paiva, Edison Ferreira de / Mauad, Thais / Silva, Luiz Fernando Ferraz da / Saldiva, Paulo Hilario Nascimento / Dolhnikoff, Marisa / Duarte-Neto, Amaro Nunes

Revista do Instituto de Medicina Tropical de Sao Paulo

2023 Volume 65, Page(s) e36

Abstract: ... died due to refractory shock. The ultrasound-guided minimally invasive autopsy diagnosed VL ... for the treatment of COVID-19, the patient developed acute respiratory failure, with chest radiographic changes, and ...

Abstract	Visceral leishmaniasis (VL) is a chronic vector-borne zoonotic disease caused by trypanosomatids, considered endemic in 98 countries, mainly associated with poverty. About 50,000-90,000 cases of VL occur annually worldwide, and Brazil has the second largest number of cases in the world. The clinical picture of VL is fever, hepatosplenomegaly, and pancytopenia, progressing to death in 90% of cases due to secondary infections and multi-organ failure, if left untreated. We describe the case of a 25-year-old female who lived in the metropolitan area of Sao Paulo, who had recently taken touristic trips to several rural areas in Southeastern Brazil and was diagnosed post-mortem. During the hospitalization in a hospital reference for the treatment of COVID-19, the patient developed acute respiratory failure, with chest radiographic changes, and died due to refractory shock. The ultrasound-guided minimally invasive autopsy diagnosed VL (macrophages containing amastigote forms of Leishmania in the spleen, liver and bone marrow), as well as pneumonia and bloodstream infection by gram-negative bacilli.
MeSH term(s)	Female ; Humans ; Adult ; Leishmaniasis, Visceral/complications ; Leishmaniasis, Visceral/diagnosis ; Leishmaniasis, Visceral/drug therapy ; Diagnosis, Differential ; Autopsy ; COVID-19/diagnosis ; Brazil ; Respiratory Insufficiency/diagnosis ; COVID-19 Testing
Language	English
Publishing date	2023-06-01
Publishing country	Brazil
Document type	Case Reports
ZDB-ID	128928-7
ISSN	1678-9946 ; 0036-4665
ISSN (online)	1678-9946
ISSN	0036-4665
DOI	10.1590/S1678-9946202365036
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Article ; Online: Comorbidities and autopsy findings of COVID-19 deaths and their association with time to death: a systematic review and meta-analysis.

Martín-Martín, Jaime / Martín-Cazorla, Fernando / Suárez, Juan / Rubio, Leticia / Martín-de-Las-Heras, Stella

Current medical research and opinion

2022 Volume 38, Issue 5, Page(s) 785–792

Abstract: ... a profile of the deceased and the likelihood of time to death.: Methods: A systematic review was carried ... Patients with vascular disease, heart disease, and diabetes died significantly in a shorter period of time ... reported in the microscopic postmortem findings, and these patients died in a shorter period of time ...

Abstract	Objective: Examination of postmortem findings can help establish effective therapeutic strategies to reduce mortality. The aim of this study was therefore to review complete autopsy cases and their postmortem findings and comorbidities associated with death caused by COVID-19, in order to establish a profile of the deceased and the likelihood of time to death. Methods: A systematic review was carried out following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and meets Cochrane criteria recommendations (PROSPERO registration number CRD 42020209649). An electronic search in the databases Pubmed, Scopus, Web of Science, Wiley Online Library, and Scientific Electronic Library Online (SciELO) was performed. Results: The search strategy yielded a total of 25 articles where 140 cases of complete autopsies were reported. The most prevalent comorbidity was vascular diseases. Patients with vascular disease, heart disease, and diabetes died significantly in a shorter period of time. Autopsies mainly focused on the lungs. The proliferative phase of Diffuse Alveolar Damage (DAD) was the most reported in the microscopic postmortem findings, and these patients died in a shorter period of time. However, individuals aged over 80 years significantly presented fibrotic phase of DAD at the time of death. The kidney was the second most affected organ with thrombosis and tubular damage, followed by the liver with congestion and necrosis. Conclusion: Given that accurate information of complete autopsies findings is still scarce, it is necessary to perform complete autopsies by examining organs other than the lungs in order to provide information to improve new treatment strategies in patients with a high risk of mortality.
MeSH term(s)	Aged ; Autopsy ; COVID-19 ; Comorbidity ; Humans ; Lung ; SARS-CoV-2 ; Vascular Diseases
Language	English
Publishing date	2022-03-31
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	80296-7
ISSN	1473-4877 ; 0300-7995
ISSN (online)	1473-4877
ISSN	0300-7995
DOI	10.1080/03007995.2022.2050110
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Article ; Online: Postmodernism and the decline of the clinical autopsy.

Dell'Aquila, Marco / Vetrugno, Giuseppe / Grassi, Simone / Stigliano, Egidio / Oliva, Antonio / Rindi, Guido / Arena, Vincenzo

Virchows Archiv : an international journal of pathology

2021 Volume 479, Issue 4, Page(s) 861–863

MeSH term(s)	Autopsy/trends ; COVID-19 ; Health Knowledge, Attitudes, Practice ; Humans ; Pathology/trends ; Postmodernism ; Time Factors
Language	English
Publishing date	2021-08-02
Publishing country	Germany
Document type	Letter
ZDB-ID	1184867-4
ISSN	1432-2307 ; 0945-6317
ISSN (online)	1432-2307
ISSN	0945-6317
DOI	10.1007/s00428-021-03166-7
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Article ; Online: Impact of the COVID-19 pandemic on pathological autopsy practices in Japan.

Hirata, Yuichiro / Iida, Shun / Arashiro, Takeshi / Nagasawa, Sayaka / Saitoh, Hisako / Abe, Hiroyuki / Ikemura, Masako / Makino, Yohsuke / Sawa, Rintaro / Iwase, Hirotaro / Ushiku, Tetsuo / Suzuki, Tadaki / Akitomi, Shinji

Pathology international

2023 Volume 73, Issue 3, Page(s) 120–126

Abstract: ... with pathologists, of which 227 responded. In cases where a confirmed diagnosis of COVID-19 was not made at the time ... into the pathogenesis of COVID-19. The precise effect of this pandemic on autopsy procedures in Japan, especially ... of autopsy, many facilities counted them as suspected COVID-19 cases if pneumonia was suspected clinically ...

Abstract	During the coronavirus disease 2019 (COVID-19) pandemic, autopsies have provided valuable insights into the pathogenesis of COVID-19. The precise effect of this pandemic on autopsy procedures in Japan, especially in instances unrelated to COVID-19, has not yet been established. Therefore, we conducted a questionnaire survey from December 2020 to January 2021 regarding the status of pathological autopsy practices in Japan during the first year of the COVID-19 pandemic. The questionnaire was sent to 678 medical facilities with pathologists, of which 227 responded. In cases where a confirmed diagnosis of COVID-19 was not made at the time of autopsy, many facilities counted them as suspected COVID-19 cases if pneumonia was suspected clinically. At around half of the sites, autopsies were prohibited for suspected COVID-19 cases. In addition, the number of autopsies of non-COVID-19 cases during the pandemic period was also investigated, and a significant decrease was observed compared with the incidence in the pre-pandemic period. The COVID-19 pandemic has affected not only the autopsies of COVID-19 cases but also the entire practice of pathological autopsies. It is necessary to establish a system that supports the implementation of pathological autopsy practices during the pandemic of an emerging infectious disease.
MeSH term(s)	Humans ; COVID-19 ; Autopsy ; Pandemics ; SARS-CoV-2 ; Japan/epidemiology
Language	English
Publishing date	2023-01-04
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1194850-4
ISSN	1440-1827 ; 1320-5463
ISSN (online)	1440-1827
ISSN	1320-5463
DOI	10.1111/pin.13306
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Article: MORPHOLOGICAL ASSESSMENT OF THE LUNGS IN POST-COVID-19 SYNDROME: ANALYSIS OF AUTOPSY MATERIAL.

Myroshnychenko, Mykhailo S / Pasiyeshvili, Nana M / Kapustnyk, Nataliia V / Markovskiy, Volodymyr D / Kalashnyk-Vakulenko, Yuliia M / Zaytseva, Olga V / Bondarenko, Maryna A / Morozov, Oleksandr V / Molodan, Dmytro V

Wiadomosci lekarskie (Warsaw, Poland : 1960)

2023 Volume 76, Issue 5 pt 1, Page(s) 1014–1021

Abstract: ... Patients and methods: Materials and methods: The material of the study was autopsy material - fragments ... Objective: The aim was to reveal the morphological features of the lungs in post-COVID-19 syndrome ... COVID-19 of varying severity, and after the treatment of this infection, they had various manifestations ...

Abstract	Objective: The aim was to reveal the morphological features of the lungs in post-COVID-19 syndrome. Patients and methods: Materials and methods: The material of the study was autopsy material - fragments of the lung tissue from 96 deceased (59 men and 37 women). During the lifetime, all patients had in anamnesis COVID-19 of varying severity, and after the treatment of this infection, they had various manifestations of respiratory failure until death. The average duration of the post-COVID-19 period was 148.6±9.5 days. Based on the severity of COVID-19 in anamnesis, all cases were divided into three groups. Group 1 included 39 cases with mild COVID-19 in anamnesis. Group 2 included 24 cases with moderate severity of COVID-19 in an-amnesis. Group 3 included 33 cases with severe COVID-19 in anamnesis. Histological, histochemical, morphometric and statistical research methods were used. Results: Results: Morphological features of the lungs in post-COVID-19 syndrome were the presence of pneumosclerosis; focal-diffuse immune cells infiltration; emphysematous and atelectatic changes; degenerative-desquamatic changes in the alveolar epithelium; metaplastic changes of connective tissue; dystrophic calcification; dystrophic, metaplastic and dysplastic changes in the epithelial layer of bronchial tree; hemodynamic disorders. Pneumosclerosis, focal-diffuse immune cells infiltration, alterative changes in the alveolar epithelium, emphysematous and atelectatic changes, hemodynamic disorders increased with an increase the severity of COVID-19. Metaplastic changes of connective tissue, dystrophic calcification, dystrophic, metaplastic and dysplastic changes in epithelial layer of bronchial tree did not depend on the severity of the infection. Conclusion: Conclusions: The changes identified by the authors help to explain pulmonary manifestations of post-COVID-19 syndrome. They should be the basis for the oncological alertness formation among doctors, the development of rehabilitation and treatment measures for such category of patients.
MeSH term(s)	Male ; Humans ; Female ; COVID-19 ; Post-Acute COVID-19 Syndrome ; Autopsy ; SARS-CoV-2 ; Lung/pathology ; Hyperplasia/pathology
Language	English
Publishing date	2023-06-16
Publishing country	Poland
Document type	Journal Article
ZDB-ID	414731-5
ISSN	0043-5147 ; 1895-0485 ; 0860-8865
ISSN	0043-5147 ; 1895-0485 ; 0860-8865
DOI	10.36740/WLek202305120
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Article: Viable SARS-CoV-2 Omicron sub-variants isolated from autopsy tissues.

Maffia-Bizzozero, Santiago / Cevallos, Cintia / Lenicov, Federico Remes / Freiberger, Rosa Nicole / Lopez, Cinthya Alicia Marcela / Guano Toaquiza, Alex / Sviercz, Franco / Jarmoluk, Patricio / Bustos, Cristina / D'Addario, Adriana Claudia / Quarleri, Jorge / Delpino, M Victoria

Frontiers in microbiology

2023 Volume 14, Page(s) 1192832

Abstract: ... of long COVID.: Methods: In the present study, we investigated autopsy materials obtained from 21 ... cadaveric donors with documented first infection or reinfection at the time of death. The cases studied ... with SARS-CoV-2, the causative agent of coronavirus disease 2019 (COVID-19). The virus is known to persist ...

Abstract	Introduction: Pulmonary and extrapulmonary manifestations have been described after infection with SARS-CoV-2, the causative agent of coronavirus disease 2019 (COVID-19). The virus is known to persist in multiple organs due to its tropism for several tissues. However, previous reports were unable to provide definitive information about whether the virus is viable and transmissible. It has been hypothesized that the persisting reservoirs of SARS-CoV-2 in tissues could be one of the multiple potentially overlapping causes of long COVID. Methods: In the present study, we investigated autopsy materials obtained from 21 cadaveric donors with documented first infection or reinfection at the time of death. The cases studied included recipients of different formulations of COVID-19 vaccines. The aim was to find the presence of SARS-CoV-2 in the lungs, heart, liver, kidneys, and intestines. We used two technical approaches: the detection and quantification of viral genomic RNA using RT-qPCR, and virus infectivity using permissive Results: All tissues analyzed showed the presence of SARS-CoV-2 genomic RNA but at dissimilar levels ranging from 1.01 × 10 Discussion: These findings highlight that SARS-CoV-2 can spread to multiple tissue locations such as the lungs, heart, liver, kidneys, and intestines, both after primary infection and after reinfections with the Omicron variant, contributing to extending knowledge about the pathogenesis of acute infection and understanding the sequelae of clinical manifestations that are observed during post-acute COVID-19.
Language	English
Publishing date	2023-05-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2587354-4
ISSN	1664-302X
ISSN	1664-302X
DOI	10.3389/fmicb.2023.1192832
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