Use of post-mortem computed tomography during the COVID-19 pandemic

Area of Science:

• Forensic pathology
• Medical imaging
• Public health

Background:

• Post mortem computed tomography (PMCT) is increasingly utilized in England and Wales to complement or substitute traditional invasive autopsies.
• Coroner's autopsy services remained operational during the COVID-19 pandemic, identifying deaths from undiagnosed COVID-19.
• Infection risk concerns led to PMCT replacing traditional autopsies in some regions and modified scanning protocols.

Purpose of the Study:

• To evaluate the role of PMCT in determining cause of death.
• To assess PMCT's utility in identifying COVID-19 related deaths.
• To understand the impact of health and safety concerns on post mortem practices.

Main Methods:

• Utilizing PMCT and coronary angiography to ascertain the cause of death.
• Analyzing CT findings, specifically bilateral ground-glass opacities and consolidation in lungs.
• Confirming COVID-19 diagnosis with post mortem nose and throat swabs.

Main Results:

• PMCT and coronary angiography can determine the cause of death in approximately 70% of cases without invasive examination.
• PMCT assisted in identifying potential COVID-19 deaths and selecting cases for viral studies.
• CT lung findings, while not specific, were indicative of COVID-19, confirmed by swabs.

Conclusions:

• PMCT is an effective tool for non-invasive cause of death determination.
• PMCT played a crucial role in identifying COVID-19 deaths during the pandemic.
• Modified PMCT protocols addressed health and safety concerns while maintaining diagnostic capabilities.