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Impact of the COVID-19 pandemic on pathological autopsy practices in Japan
Yuichiro Hirata1,2, Shun Iida1, Takeshi Arashiro1,3
1Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan.
Insights
The coronavirus disease 2019 (COVID-19) pandemic significantly impacted autopsy practices in Japan, leading to a decrease in both COVID-19 and non-COVID-19 autopsies. Many facilities prohibited autopsies for suspected COVID-19 cases, highlighting the need for pandemic support systems.
Area of Science:
- Pathology
- Infectious Diseases
- Public Health
Background:
- Autopsies are crucial for understanding disease pathogenesis, including COVID-19.
- The impact of the COVID-19 pandemic on autopsy practices in Japan, particularly for non-COVID-19 cases, was unclear.
Purpose of the Study:
- To investigate the status of pathological autopsy practices in Japan during the first year of the COVID-19 pandemic.
- To assess the effect of the pandemic on both COVID-19 and non-COVID-19 autopsies.
Main Methods:
- A questionnaire survey was conducted from December 2020 to January 2021.
- The survey targeted 678 medical facilities with pathologists, receiving 227 responses.
- Data collected included changes in autopsy procedures and case classifications during the pandemic.
Main Results:
- Many facilities classified clinically suspected pneumonia cases as suspected COVID-19 during autopsy.
- Approximately half of the surveyed facilities prohibited autopsies for suspected COVID-19 cases.
- A significant decrease in the number of non-COVID-19 autopsies was observed compared to the pre-pandemic period.
Conclusions:
- The COVID-19 pandemic has broadly impacted pathological autopsy practices, not just for COVID-19 cases.
- There is a critical need to develop systems supporting pathological autopsy implementation during emerging infectious disease pandemics.
Abstract:
During the coronavirus disease 2019 (COVID-19) pandemic, autopsies have provided valuable insights into the pathogenesis of COVID-19. The precise effect of this pandemic on autopsy procedures in Japan, especially in instances unrelated to COVID-19, has not yet been established. Therefore, we conducted a questionnaire survey from December 2020 to January 2021 regarding the status of pathological autopsy practices in Japan during the first year of the COVID-19 pandemic. The questionnaire was sent to 678 medical facilities with pathologists, of which 227 responded. In cases where a confirmed diagnosis of COVID-19 was not made at the time of autopsy, many facilities counted them as suspected COVID-19 cases if pneumonia was suspected clinically. At around half of the sites, autopsies were prohibited for suspected COVID-19 cases. In addition, the number of autopsies of non-COVID-19 cases during the pandemic period was also investigated, and a significant decrease was observed compared with the incidence in the pre-pandemic period. The COVID-19 pandemic has affected not only the autopsies of COVID-19 cases but also the entire practice of pathological autopsies. It is necessary to establish a system that supports the implementation of pathological autopsy practices during the pandemic of an emerging infectious disease.
