COVID-19 Autopsy in India: Protocols, Procedures, and Experiences

Area of Science:

• Pathology
• Infectious Diseases
• Public Health

Background:

• Coronavirus disease 2019 (COVID-19) presents a global health crisis, necessitating autopsy studies for understanding its pathophysiology.
• Autopsy data is crucial for disease comprehension, yet such studies are scarce, particularly in developing nations.
• Conducting autopsies on infectious cases requires specialized infrastructure and stringent safety protocols.

Purpose of the Study:

• To conduct a complete pathological autopsy on a COVID-19 patient to identify histopathological changes.
• To correlate autopsy findings with clinical data, including hospitalization duration, mechanical ventilation, comorbidities, and biochemical parameters.
• To establish protocols for safe and effective autopsies in infectious cases, especially in resource-limited settings.

Main Methods:

• A complete pathological autopsy was performed on a COVID-19 patient following institutional ethical approval and family consent.
• Histopathological examination (HPE) and real-time polymerase chain reaction (RT-PCR) were conducted on collected tissues.
• Clinical and biomedical data were collected and correlated with autopsy findings.

Main Results:

• Consent was a limiting factor, obtained in only 15.3% of cases.
• Gross findings indicated viral infection and comorbidities across all organs.
• Developed and implemented protocols enabled successful completion of autopsies with good sample collection, ensuring no infection spread to the autopsy team.

Conclusions:

• Experience from 21 COVID-19 autopsies provides insights into minimal requirements for infectious case autopsies.
• Guidelines are proposed for conducting autopsies in challenging conditions, particularly relevant for developing countries.
• Successful execution of autopsies in infectious cases is achievable with appropriate protocols and precautions.