Autopsy in suspected COVID-19 cases
Tóm tắt
The severe acute respiratory syndrome (SARS)-coronavirus-2 (CoV-2) outbreak in Wuhan, China has now spread to many countries across the world including the UK with an increasing death toll. This will inevitably lead to an increase in the number of suspected coronavirus disease 2019 (COVID-19)-related deaths at autopsy. The Royal College of Pathologists has responded to this concern with the release of a briefing on autopsy practice relating to COVID-19. The following article is a summary and interpretation of these guidelines. It includes a description of hazard group 3 organisms, the category to which SARS-CoV-2 has been assigned, a brief description of what is currently known about the pathological and autopsy findings in COVID-19, a summary of the recommendations for conducting autopsies in suspected COVID-19 cases and the techniques for making the diagnosis at autopsy. It concludes by considering the clinicopathological correlation and notification of such cases.
Từ khóa
Tài liệu tham khảo
World Health Organization . Director General's remarks at the media briefing on 2019-nCoV on 11 February 2020. secondary director General's remarks at the media briefing on 2019-nCoV on 11 February 2020, 2020. Available: https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020
European Centre for Disease Prevention and Control . Threats and outbreaks: COVID-19 secondary threats and outbreaks: COVID-19, 2020. Available: https://www.ecdc.europa.eu/en/novel-coronavirus-china
Osborn M , Lucas S , Stewart R , et al . Autopsy practice relating to possible cases of COVID-19 (2019-nCov, novel coronavirus from China 2019/2020) secondary autopsy practice relating to possible cases of COVID-19 (2019-nCov, novel coronavirus from China 2019/2020), 2020. Available: https://www.rcpath.org/uploads/assets/d5e28baf-5789-4b0f-acecfe370eee6223/fe8fa85a-f004-4a0c-81ee4b2b9cd12cbf/Briefing-on-COVID-19-autopsy-Feb-2020.pdf
Huang, 2020, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, The Lancet, 395, 497, 10.1016/S0140-6736(20)30183-5
Wang D , Hu B , Hu C , et al . Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA 2020.doi:10.1001/jama.2020.1585
Health and Safety Executive Advisory Committee on Dangerous Pathogens . The Approved list of biological agents. secondary the Approved list of biological agents. Available: www.hse.gov.uk/pubns/misc208.pdf
Health and Safety Executive . Safe working and the prevention of infection in the mortuary and post-mortem room. secondary safe working and the prevention of infection in the mortuary and post-mortem room, 2018. Available: https://www.rcpath.org/uploads/assets/d5e28baf-5789-4b0f-acecfe370eee6223/fe8fa85a-f004-4a0c-81ee4b2b9cd12cbf/Briefing-on-COVID-19-autopsy-Feb-2020.pdf
Public Health England . COVID-19: safe handling and processing for laboratories secondary COVID-19: safe handling and processing for laboratories, 2020. Available: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-guidance-for-clinical-diagnostic-laboratories/wuhan-novel-coronavirus-handling-and-processing-of-laboratory-specimens
Xu Z , Shi L , Wang Y , et al . Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet respiratory medicine.
Tian, 2020, Pulmonary pathology of early phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer, J Thorac Oncol
Public Health England . COVID-19: investigation and initial clinical management of possible cases. secondary COVID-19: investigation and initial clinical management of possible cases, 2020. Available: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-initial-investigation-of-possible-cases/investigation-and-initial-clinical-management-of-possible-cases-of-wuhan-novel-coronavirus-wn-cov-infection
Lucas S . Autopsies on people with high-risk infections. In: The hospital autopsy: a manual of fundamental autopsy practice. 3rd edition. London, UK: Hodder Arnold, 2010.
NBS T . Hbn 20 facilities for mortuary and post-mortem room services (3rd edition). secondary HbN 20 facilities for mortuary and post-mortem room services (3rd edition), 2005. Available: www.thenbs.com/PublicationIndex/documents/details?Pub=NHS&DocID=275892
Castillo, 2016, Validity of a minimally invasive autopsy for cause of death determination in adults in Mozambique: an observational study, PLoS Med, 13, 10.1371/journal.pmed.1002171
Zhao, 2020, Relation between chest CT findings and clinical conditions of coronavirus disease (COVID-19) pneumonia: a multicenter study, AJR Am J Roentgenol, 1
Public Health England . COVID-19: guidance for sampling and for diagnostic laboratories secondary COVID-19: guidance for sampling and for diagnostic laboratories, 2020. Available: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-guidance-for-clinical-diagnostic-laboratories
Henwood, 2020, Coronavirus disinfection in histopathology, J Histotechnol, 16, 1