Coronial postmortem reports and indirect COVID-19 pandemic-related mortality

Autor: Robert Pell, S Kim Suvarna, Nigel Cooper, Guy Rutty, Anna Green, Michael Osborn, Peter Johnson, Alison Hayward, Justine Durno, Theodore Estrin-Serlui, Marion Mafham, Ian S D Roberts
Rok vydání: 2022
Předmět:
Zdroj: Journal of Clinical Pathology
ISSN: 1472-4146
0021-9746
DOI: 10.1136/jclinpath-2021-208003
Popis: AimsWidespread disruption of healthcare services and excess mortality not directly attributed to COVID-19 occurred between March and May 2020. We undertook the first UK multicentre study of coroners’ autopsies before and during this period using postmortem reports.MethodsWe reviewed reports of non-forensic coroners’ autopsies performed during the first COVID-19 lockdown (23 March to 8 May 2020), and the same period in 2018. Deaths were categorised as natural non-COVID-19, COVID-19-related, non-natural (suicide, drug and alcohol-related, traumatic, other). We provided opinion regarding whether delayed access to medical care or changes in behaviour due to lockdown were a potential factor in deaths.ResultsSeven centres covering nine coronial jurisdictions submitted a total of 1100 coroners’ autopsies (498 in 2018, 602 in 2020). In only 54 autopsies was death attributed to COVID-19 (9%). We identified a significant increase in cases where delays in accessing medical care potentially contributed to death (10 in 2018, 44 in 2020). Lockdown was a contributing factor in a proportion of suicides (24%) and drug and alcohol-related deaths (12%).ConclusionsPostmortem reports have considerable utility in evaluating excess mortality due to healthcare and wider societal disruption during a pandemic. They provide information at an individual case level that is not available from assessment of death certification data. Detailed evaluation of coroners’ autopsy reports, supported by appropriate regulatory oversight, is recommended to mitigate disruption and indirect causes of mortality in future pandemics. Maintaining access to healthcare, including substance misuse and mental health services, is an important consideration.
Databáze: OpenAIRE
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