Safe Autopsy Procedures for COVID-19: Experience of One Research Center

Area of Science:

• Pathology
• Infectious Diseases
• Public Health

Background:

• Limited early guidelines existed for safely performing autopsies during the COVID-19 pandemic.
• Uncertainties remained regarding aerosol transmission risks of SARS-CoV-2.
• The need to study the novel pathogen necessitated continued autopsies while managing infection risks.

Purpose of the Study:

• To implement and evaluate revised autopsy protocols to mitigate SARS-CoV-2 infection risks for personnel.
• To assess the effectiveness of new safety measures during autopsies of COVID-19 positive individuals.

Main Methods:

• Modified autopsy protocols starting March 2020, initially restricting to brain autopsies.
• Implemented engineering, environmental, and procedural changes, including aerosol containment during skullcap removal.
• Resumed whole-body autopsies in June 2020 after protocol implementation; spinal cord removal was suspended.

Main Results:

• Between January 2020 and February 2022, 162 subjects underwent autopsy (36 SARS-CoV-2 positive).
• 94 exposures occurred involving 19 staff; only 2 staff tested positive within 7 days of a SARS-CoV-2 positive autopsy.
• This indicates a drastic reduction in enhanced SARS-CoV-2 infection risk for autopsy personnel.

Conclusions:

• Revised autopsy protocols significantly reduce the risk of SARS-CoV-2 infection for autopsy personnel.
• The implemented safety measures, including aerosol containment, are effective in mitigating transmission.
• Recommendations are made for other laboratories to adopt these protocols for autopsies involving communicable diseases.