COVID-19 autopsies of Istanbul

• Published in: Irish journal of medical science Vol. 191; no. 2; pp. 529 - 541
• Main Authors: Arslan, Murat Nihat, Büyük, Yalçın, Ziyade, Nihan, Elgörmüş, Neval, Şirin, Gözde, Çoban, İsmail, Gökşen, Muhammed Emin, Daş, Taner, Akçay, Arzu
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-04-2022
• Subjects: Aged; Autopsy; COVID-19; Family Medicine; Female; General Practice; Humans; Internal Medicine; Lung - pathology; Male; Medicine; Medicine & Public Health; Middle Aged; Original; Original Article; Pneumonia, Viral; Retrospective Studies; SARS-CoV-2; COVID-19; Pulmonary findings; Autopsy; Risk factors
• ISSN: 0021-1265; 1863-4362
• DOI: 10.1007/s11845-021-02602-6

Background/aims
The aim of this study is to share autopsy findings of COVID-19-positive cases and autopsy algorithms for safely handling of suspicious bodies during this pandemic.
Methods
COVID-19-positive cases of Istanbul Morgue Department were retrospectively analyzed. Sampling indications for PCR tests in suspicious deaths, macroscopic and microscopic findings obtained in cases with positive PCR tests were evaluated.
Results
In the morgue department, 345(25.8%) of overall 1336 autopsy cases were tested for COVID-19. PCR test was found positive in 26 cases. Limited autopsy procedure was performed in 7 cases, while the cause of death was determined by external examination in the remaining 19 cases. Male-to-female ratio was found 3.3:1 and mean age was 60.0 ± 13.6 among all PCR-positive cases. Cause of death was determined as viral pneumonia in fully autopsied cases. Most common findings were sticky gelatinous fluid in cavities and firm and swollen lungs, varying degrees of consolidation. In microscopy, diffuse alveolar epithelial damage, type-II pneumocyte hyperplasia, hyaline membrane formation, fibrinous exudate, and fibrinous plaques in the alveoli were the most common findings.
Conclusions
In COVID-19 autopsies, pulmonary findings were found to be prominent and the main pathology was pneumonia. Older age and findings of chronic diseases indicate that the cases were in the multirisk group in terms of COVID-19 mortality.