Background and aim: COVID-19 is an extremely challenging disease, both from a clinical and forensic point of view, and performing autopsies of COVID-19 deceased requires adequately equipped sectorial rooms and exposes health professionals to the risk of contagion. Among one of the categories that are most affected by SARS-Cov-2 infection are the elderly residents. Despite the need for prompt diagnoses, which are essential to implement all isolation measures necessary to contain the infection spread, deceased subjects in long-term care facilities are still are often diagnosed post-mortem. In this context, our study focuses on the use of post-mortem computed tomography for the diagnosis of COVID-19 infection, in conjunction with post-mortem swabs. The aim of this study was to assess the usefulness of post-mortem whole CT-scanning in identifying COVID-19 pneumonia as a cause of death, by comparing chest CT-findings of confirmed COVID-19 fatalities to control cases. Materials and methods: The study included 24 deceased subjects: 13 subjects coming from long-term care facility and 11 subjects died at home. Whole body CT scans were performed within 48 h from death in all subjects to evaluate the presence and distribution of pulmonary abnormalities typical of COVID-19-pneumonia, including: ground-glass opacities (GGO), consolidation, and pleural effusion to confirm the post-mortem diagnosis. Results: Whole-body CT scans was feasible and allowed a complete diagnosis in all subjects. In 9 (69%) of the 13 cases from long-term care facility the cause of death was severe COVID 19 pneumonia, while GGO were present in 100% of the study population. Conclusion: In the context of rapidly escalating COVID-19 outbreaks, given that laboratory tests for the novel coronavirus is time-consuming and can be falsely negative, the post-mortem CT can be considered as a reliable and safe modality to confirm COVID-19 pneumonia. This is especially true for specific postmortem chest CT-findings that are rather characteristic of COVID-19 fatalities.

Use of post-mortem chest computed tomography in Covid-19 pneumonia / De-Giorgio, F.; Cittadini, F.; Cina, A.; Cavarretta, E.; Biondi-Zoccai, G.; Vetrugno, G.; Natale, L.; Colosimo, C.; Pascali, V. L.. - In: FORENSIC SCIENCE INTERNATIONAL. - ISSN 0379-0738. - 325:(2021). [10.1016/j.forsciint.2021.110851]

Use of post-mortem chest computed tomography in Covid-19 pneumonia

Cavarretta E.
Formal Analysis
;
Biondi-Zoccai G.
Supervision
;
2021

Abstract

Background and aim: COVID-19 is an extremely challenging disease, both from a clinical and forensic point of view, and performing autopsies of COVID-19 deceased requires adequately equipped sectorial rooms and exposes health professionals to the risk of contagion. Among one of the categories that are most affected by SARS-Cov-2 infection are the elderly residents. Despite the need for prompt diagnoses, which are essential to implement all isolation measures necessary to contain the infection spread, deceased subjects in long-term care facilities are still are often diagnosed post-mortem. In this context, our study focuses on the use of post-mortem computed tomography for the diagnosis of COVID-19 infection, in conjunction with post-mortem swabs. The aim of this study was to assess the usefulness of post-mortem whole CT-scanning in identifying COVID-19 pneumonia as a cause of death, by comparing chest CT-findings of confirmed COVID-19 fatalities to control cases. Materials and methods: The study included 24 deceased subjects: 13 subjects coming from long-term care facility and 11 subjects died at home. Whole body CT scans were performed within 48 h from death in all subjects to evaluate the presence and distribution of pulmonary abnormalities typical of COVID-19-pneumonia, including: ground-glass opacities (GGO), consolidation, and pleural effusion to confirm the post-mortem diagnosis. Results: Whole-body CT scans was feasible and allowed a complete diagnosis in all subjects. In 9 (69%) of the 13 cases from long-term care facility the cause of death was severe COVID 19 pneumonia, while GGO were present in 100% of the study population. Conclusion: In the context of rapidly escalating COVID-19 outbreaks, given that laboratory tests for the novel coronavirus is time-consuming and can be falsely negative, the post-mortem CT can be considered as a reliable and safe modality to confirm COVID-19 pneumonia. This is especially true for specific postmortem chest CT-findings that are rather characteristic of COVID-19 fatalities.
2021
autopsy; Coronavirus; COVID-19; pneumonia; post mortem changes; post mortem computed tomography; adult; aged; aged, 80 and over; autopsy; COVID-19; case-control studies; female; humans; lung; male; middle aged; pleural effusion; retrospective studies; sensitivity and specificity; whole body imaging; tomography, X-Ray computed
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Use of post-mortem chest computed tomography in Covid-19 pneumonia / De-Giorgio, F.; Cittadini, F.; Cina, A.; Cavarretta, E.; Biondi-Zoccai, G.; Vetrugno, G.; Natale, L.; Colosimo, C.; Pascali, V. L.. - In: FORENSIC SCIENCE INTERNATIONAL. - ISSN 0379-0738. - 325:(2021). [10.1016/j.forsciint.2021.110851]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1643556
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