Autopsies in deaths from Covid-19: Analysis and recommendations trough a review

Abstract

Justification: The autopsy is a gold standard to determine the manner of death, providing crucial information that aids to the clinical, epidemiological and pathophysiological aspects of diseases with high death rate. The pathologic data obtained from autopsies must agree with the diagnostics and facilitate effective therapies. Being a new disease with unprecedented implications for humanity, SARS-CoV-2 infection has generated multiple scientific works to understand it from different points of view. Objective: The purposes of the review were: to analyze the available literature on autopsies, to identify the main pathological findings reported and to determine the technical conditions under which these procedures were performed. Methodology: Bibliographic search engines (PubMed, Google Scholar, Dialnet, Scielo) were utilized, using the words Autopsy, Postmortem and COVID-19, to locate the literature on autopsies of patients with SARS-CoV-2 infection. Results: We obtained 16 scientific articles that fulfilled our search criteria. In seven, 83 autopsies were reported from 54 men and 16 women, with an average age of 60.91 years. Pathology analysis focused especially on the lungs, wich were macroscopically heavy for edema and congestion. Microscopically, there was diffuse alveolar damage (hyaline or organizational membranes with angiogenesis and microthrombi) and lymphocytic infiltration. Were  also  analyzed  in   18   autopsies other organs such as heart, liver, kidney and spleen. Conclusion: Despite the increase in research reports on SARS-CoV-2 disease, autopsy-based studies are still scarce and limited. An increase in the number of autopsies performed on those who died from COVID-19 would provide greater knowledge of the characteristics of the disease, the cause of death, its extension and the effects of treatment.