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Ann Transl Med . Forensic autopsy-confirmed COVID-19-induced out-of-hospital cardiac arrest

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  • Ann Transl Med . Forensic autopsy-confirmed COVID-19-induced out-of-hospital cardiac arrest


    Ann Transl Med


    . 2021 Dec;9(23):1715.
    doi: 10.21037/atm-21-3918.
    Forensic autopsy-confirmed COVID-19-induced out-of-hospital cardiac arrest


    Laurent Fanton # 1 2 , Isabelle Nahmani # 1 2 , Marie Epain 1 , Anne-Sophie Advenier 1 , Martin Cour 2 3 , David Meyronet 2 4 , Laurent Argaud 2 3



    AffiliationsFree PMC article

    Abstract

    Background: In the setting of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, data from autopsy in subjects who died at home during lockdown are scarce. We here report the first forensic autopsy series of coronavirus disease 2019 (COVID-19)-related out-of-hospital cardiac arrest (OHCA).
    Methods: Between March and April 2020, four COVID-19-related OHCA were autopsied at the Institute of Legal Medicine of the metropolitan area of Lyon (France) according safe recommended procedures.
    Results: Four Caucasian individuals (3 men/1 woman; age: 56.8±2.1 years, body mass index: 29.5±7.4 kg/m2), presenting symptomatic COVID-19 were autopsied. Autopsies of 3 individuals reported natural death by acute respiratory failure implicating SARS-CoV-2 with typical COVID-19 pulmonary aspect of gross findings and pulmonary microscopy findings, i.e., diffusely congestive edematous lungs with peripheral thrombi and diffuse alveolar damage (DAD) at different stages of inflammatory reaction. For one individual, autopsy concluded of violent death due to suicidal acute alcohol intoxication in a patient that could no longer endure COVID-19 lockdown. No significant lesions were found in the heart.
    Conclusions: We report here OHCAs of non-cardiac cause directly implicating COVID-19 at various stages of SARS-CoV-2-related DAD. Thus, autopsy remain of interest during this epidemic, both legally and medically to better understand the pathogenic processes of this emerging infectious disease.

    Keywords: Severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2 infection); autopsy; cardiac arrest; coronavirus disease 2019 (COVID-19).

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