Minimally Invasive Autopsy Practice in COVID-19 Cases: Biosafety and Findings
Natalia Rakislova, Lorena Marimón, Mamudo R. Ismail, Carla Carrilho, Fabiola Fernandes, Melania Ferrando, Paola Castillo, Maria Teresa Rodrigo‐Calvo, José Guerrero, Estrella Ortiz, Abel Muñoz-Beatove, Miguel J. Martínez, Juan Carlos Hurtado, Mireia Navarro, Quique Bassat, María Maixenchs, Vima Delgado, Edwin Wallong, Anna Aceituno, Jean Kim, Christina R. Paganelli, Norman Goco, Ibán Aldecoa, Antonio Martı́nez, Daniel Martı́nez, José Ramírez, Gieri Cathomas, Myriam Haab, Clara Menéndez, Jaume Ordï
Abstract
Postmortem studies are crucial for providing insight into emergent diseases. However, a complete autopsy is frequently not feasible in highly transmissible diseases due to biohazard challenges. Minimally invasive autopsy (MIA) is a needle-based approach aimed at collecting samples of key organs without opening the body, which may be a valid alternative in these cases. We aimed to: (a) provide biosafety guidelines for conducting MIAs in COVID-19 cases, (b) compare the performance of MIA versus complete autopsy, and (c) evaluate the safety of the procedure. Between October and December 2020, MIAs were conducted in six deceased patients with PCR-confirmed COVID-19, in a basic autopsy room, with reinforced personal protective equipment. Samples from the lungs and key organs were successfully obtained in all cases. A complete autopsy was performed on the same body immediately after the MIA. The diagnoses of the MIA matched those of the complete autopsy. In four patients, COVID-19 was the main cause of death, being responsible for the different stages of diffuse alveolar damage. No COVID-19 infection was detected in the personnel performing the MIAs or complete autopsies. In conclusion, MIA might be a feasible, adequate and safe alternative for cause of death investigation in COVID-19 cases.