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Author Notes:

Rachel L. Geller, DeKalb County Medical Examiner’s, Kensington Rd., Decatur, GA, 30032, USA. Email: rgeller@dekalbcountyga.gov

Rachel L. Geller, MD Conceptualization, investigation, methodology, resources, visualization, Writing – original draft, Writing – review and editing, Jenna L. Aungst Conceptualization, methodology, visualization, Writing – original draft, Writing – review and editing, Anna Newton-Levins, MPH, PhD Methodology, Writing – review and editing, Geoffrey P. Smith, MD Supervision, resources, conceptualization, Marina B. Mosunjac, MD Investigation, Mario I. Mosunjac, MD Investigation, Christy S. Cunningham, DO Resources, investigation, Gerald T. Gowitt, MD Supervision, resources, Writing – review and editing.

We would like to thank our investigative staff, administrative team, and autopsy technicians for their efforts during the pandemic. We would like to recognize dedicated COVID-19 autopsy technician Marquel Johnson for assisting with the vast majority of suspected COVID-19 cases in 2020 and his efforts in the development of a COVID-19 autopsy protocol at our office. We would also like to recognize technician Erika Burgess for photographs taken at the time of autopsy.

Disclosures: None

Subject:

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Medicine, Legal
  • Legal Medicine
  • Autopsy
  • COVID-19
  • SARS-CoV-2
  • Retrospective
  • Mortality
  • UNITED-STATES
  • SARS-COV-2

Is it COVID-19? The value of medicolegal autopsies during the first year of the COVID-19 pandemic

Tools:

Journal Title:

FORENSIC SCIENCE INTERNATIONAL

Volume:

Volume 330

Publisher:

, Pages 111106-111106

Type of Work:

Article | Final Publisher PDF

Abstract:

Objectives: We describe the experience of a busy metropolitan medical examiner's office in the United States and share our navigation of the COVID-19 autopsy decision-making process. We describe key gross and microscopic findings that, with appropriate laboratory testing, should direct a pathologist towards a COVID-19-related cause of death. Material and methods: We performed a retrospective review of 258 suspected and/or confirmed COVID-19 associated deaths that occurred between March 5, 2020, and March 4, 2021. Results: A total of 62 cases due to fatal COVID-19 were identified; autopsy findings included diffuse alveolar damage, acute bronchopneumonia and lobar pneumonia, and pulmonary thromboemboli. Nine additional decedents had a nasopharyngeal swab positive for SARS-CoV-2 and a cause of death unrelated to COVID-19. Forty-seven cases with COVID-19-like symptoms showed no laboratory or histopathologic evidence of SARS-CoV-2 infection; the most common causes of death in this group were hypertensive or atherosclerotic cardiovascular disease, complications of chronic alcoholism, and pulmonary thromboemboli unrelated to infection. Conclusions: The clinical findings associated with COVID-19 are not specific; a broad differential diagnosis should be embraced when decedents present with cough or shortness of breath. An autopsy may be indicated to identify a cause of death unrelated to COVID-19.

Copyright information:

© 2021 Elsevier B.V. All rights reserved.

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