Ultrasound-Guided Minimally Invasive Tissue Sampling: A Minimally Invasive Autopsy Strategy During the COVID-19 Pandemic in Brazil, 2020

Ultrasound-Guided Minimally Invasive Tissue Sampling: A Minimally Invasive Autopsy Strategy During the COVID-19 Pandemic in Brazil, 2020

Minimally invasive autopsies, also known as minimally invasive tissue sampling (MITS), have proven to be an alternative to complete diagnostic autopsies (CDAs) in places or situations where this procedure cannot be performed. During the coronavirus disease 2019 (COVID-19) pandemic, CDAs were suspend...

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Published in:Clinical infectious diseases Vol. 73; no. Suppl_5; pp. S442 - S453
Main Authors: Duarte-Neto, Amaro Nunes, Ferraz da Silva, Luiz Fernando, Monteiro, Renata Aparecida de Almeida, Theodoro Filho, Jair, Leite, Thabata Larissa Luciano Ferreira, de Moura, Catia Sales, Gomes-Gouvêa, Michele Soares, Pinho, João Renato Rebellho, Kanamura, Cristina Takami, de Oliveria, Ellen Pierre, Bispo, Kely Cristina Soares, Arruda, Cássia, Dos Santos, Aline Brito, Aquino, Flavia Cristina Gonçalves, Caldini, Elia Garcia, Mauad, Thais, Saldiva, Paulo Hilário Nascimento, Dolhnikoff, Marisa
Format: Journal Article
Language:English
Published: United States Oxford University Press 15-12-2021
Subjects:
Autopsy
Brazil - epidemiology
COVID-19
COVID-19 Testing
Humans
Pandemics
SARS-CoV-2
Supplement
Ultrasonography, Interventional
Brazil
COVID-19
pathology
minimally invasive tissue sampling
ultrasound guided biopsy
minimally invasive autopsy
autopsy safety
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Summary:Minimally invasive autopsies, also known as minimally invasive tissue sampling (MITS), have proven to be an alternative to complete diagnostic autopsies (CDAs) in places or situations where this procedure cannot be performed. During the coronavirus disease 2019 (COVID-19) pandemic, CDAs were suspended by March 2020 in Brazil to reduce biohazard. To contribute to the understanding of COVID-19 pathology, we have conducted ultrasound (US)-guided MITS as a strategy. This case series study includes 80 autopsies performed in patients with COVID-19 confirmed by laboratorial tests. Different organs were sampled using a standardized MITS protocol. Tissues were submitted to histopathological analysis as well as immunohistochemical and molecular analysis and electron microscopy in selected cases. US-guided MITS proved to be a safe and highly accurate procedure; none of the personnel were infected, and accuracy ranged from 69.1% for kidney, up to 90.1% for lungs, and reaching 98.7% and 97.5% for liver and heart, respectively. US-guided MITS provided a systemic view of the disease, describing the most common pathological findings and identifying viral and other infectious agents using ancillary techniques, and also allowed COVID-19 diagnosis confirmation in 5% of the cases that were negative in premortem and postmortem nasopharyngeal/oropharyngeal swab real-time reverse-transcription polymerase chain reaction. Our data showed that US-guided MITS has the capacity similar to CDA not only to identify but also to characterize emergent diseases.
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A. N. D. N., L. F. F. d. S., and R. A. d. A. M. contributed equally to this work.
T. M., P. H. N. S., and M. D. contributed equally to this work.
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciab885