Title
A Postmortem Portrait of the Coronavirus Disease 2019 (COVID-19) Pandemic: A Large Multiinstitutional Autopsy Survey Study.
Publication Date
2021
Journal Title
Arch Pathol Lab Med
Abstract
Context
This study represents the largest compilation to date of clinical and postmortem data from decedents with coronavirus disease 2019 (COVID-19). It will auZucker School of Medicine at Hofstra/Northwellnt previously published small series of autopsy case reports, refine clinicopathologic considerations, and improve the accuracy of future vital statistical reporting.
Objective
To accurately reflect the pre-existing diseases and pathologic conditions of decedents with Sars-CoV-2 infection through autopsy.
Design
Comprehensive data from 135 autopsy evaluations of COVID-19-positive decedents is presented, including histologic assessment. Postmortem examinations were performed by 36 pathologists at 19 medical centers or forensic institutions in the United States and Brazil. Data from each autopsy were collected through the online submission of multiple choice and openended survey responses.
Results
Patients dying of or with COVID-19 had an average of 8.89 pathologic conditions documented at autopsy, spanning a combination of prior chronic disease and acute conditions acquired during hospitalization. Virtually all decedents were cited as having more than one preexisting condition, encompassing an average of 2.88 such diseases each. Clinical conditions during terminal hospitalization were cited 395 times for the 135 autopsied decedents and predominantly encompassed acute failure of multiple organ systems and/or impaired coagulation. Myocarditis was rarely cited.
Conclusions
Cause-of-death statements in both autopsy reports and death certificates may not encompass the severity or spectrum of co-morbid conditions in those dying of or with COVID-19. If supported by additional research, this finding may have implications for public health decisions and reporting moving forward through the pandemic.
Document Type
Article
Status
Faculty
Facility
School of Medicine
Primary Department
Pathology and Laboratory Medicine
Additional Departments
COVID-19 Publications
PMID
DOI
10.5858/arpa.2020-0786-sa