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

Francesca Cittadini, Giuseppe Vetrugno, Luigi Natale, Vincenzo Lorenzo Pascali, Alessandro Cina, Elena Cavarretta, Giuseppe Biondi-Zoccai

Risultato della ricerca: Contributo in rivistaArticolo in rivista

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.
Lingua originaleEnglish
pagine (da-a)110851-110851
Numero di pagine1
RivistaForensic Science International
Volume325
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Autopsy
  • Tomography, X-Ray Computed
  • COVID-19
  • Pneumonia
  • Post mortem changes
  • Post mortem computed tomography
  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Female
  • Humans
  • Lung
  • Male
  • Middle Aged
  • Pleural Effusion
  • Retrospective Studies
  • Sensitivity and Specificity
  • Whole Body Imaging
  • Coronavirus

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