Postmortem radiologic and pathologic findings in COVID-19: The Toronto experience with pre-hospitalization deaths in the community
| Autor: | Patrick J. H. Kim, Andrew S. Williams, Jennifer M. Dmetrichuk, Michael S. Pollanen |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Autopsy Disease 01 natural sciences Article Pathology and Forensic Medicine 03 medical and health sciences autopsy 0302 clinical medicine postmortem CT scan medicine Humans 030216 legal & forensic medicine Diffuse alveolar damage Forensic Pathology Lung Aged Aged 80 and over Ontario Medical treatment SARS-CoV-2 business.industry pandemic General surgery Public health public health 010401 analytical chemistry COVID-19 Middle Aged Immunohistochemistry 0104 chemical sciences Community-Acquired Infections medicine.anatomical_structure Female Histopathology Tomography X-Ray Computed business Law |
| Zdroj: | Forensic Science International |
| ISSN: | 0379-0738 |
| DOI: | 10.1016/j.forsciint.2021.110755 |
| Popis: | Over a year after the initial emergence of the disease, the COVID-19 pandemic continues to strain healthcare systems worldwide. The value of feedback and connection between clinical care, public health, and death investigation systems has never been more clear. To this end, knowledge of the radiologic and histopathologic features of fatal COVID-19 is critical for those working with the living and the dead. Most of the medical descriptions of COVID-19 are either focused on clinical in vivo medical imaging or autopsies performed following an intensive course of treatment over days to weeks prior to death, rather than deaths in the community prior to hospitalization. Here we report the postmortem computed tomography (PMCT) and lung histopathology in five fatal cases of COVID-19 that were subject to medicolegal death investigation. All individuals died in the community without medical treatment, or after a brief terminal admission to hospital. In these cases, the main PMCT findings included: diffuse lung changes including ground glass-type opacifications, a "crazy paving" appearance, variable areas of more dense consolidation, and relatively few areas of spared/less involved lung parenchyma. The unifying histopathology was diffuse alveolar damage in various stages of cellular evolution. In all cases, the pattern of PMCT and the lung histopathology corroborated the diagnosis of COVID-19. We propose the routine use of PMCT as a potential screening tool for the identification of COVID-19 related fatalities in the medicolegal setting where a paucity of historical information may not otherwise permit the identification of this disease prior to autopsy. |
| Databáze: | OpenAIRE |
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