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Jpn J Infect Dis
. 2023 Jun 30.
doi: 10.7883/yoken.JJID.2023.140. Online ahead of print. Analysis of COVID-19 in tissues acquired by minimally invasive autopsy in out-of-hospital deaths with postmortem degeneration
Yuichiro Hirata 1 2 , Yohsuke Makino 2 3 , Shun Iida 1 , Harutaka Katano 1 , Sayaka Nagasawa 2 , Hirofumi Rokutan 4 , Munetoshi Hinata 4 , Akiko Iwasaki 4 , Yoichi Yasunaga 4 , Hiroyuki Abe 4 , Masako Ikemura 4 , Ayumi Motomura 2 3 5 , Kei Kira 2 3 , Susumu Kobayashi 3 , Shigeki Tsuneya 2 3 , Suguru Torimitsu 2 3 , Isao Yamamoto 6 , Kimiko Nakagawa 6 , Iwao Hasegawa 6 , Shinji Akitomi 3 7 , Daisuke Yajima 5 , Tetsuo Ushiku 4 , Hisako Saitoh 2 8 , Tadaki Suzuki 1 , Hirotaro Iwase 2 3
Affiliations
Minimally invasive autopsy (MIA) is an alternative to full autopsy for collection of tissue samples from patient's bodies, using an instrument such as a biopsy needle. MIA has been conducted in many cases of coronavirus disease 2019 (COVID-19) and contributed to elucidation of the pathogenesis of the disease. However, most of these cases were hospital deaths, and there are few reports on the application of MIA in out-of-hospital deaths with varying extent of postmortem changes. In this study, MIA and autopsy were both performed in 15 COVID-19 cases 2-30 days after death, including 11 out-of-hospital deaths. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome detection by reverse transcriptase quantitative polymerase chain reaction using MIA samples was mostly consistent with that using autopsy samples, especially for lung tissue, even in out-of-hospital cases. MIA had high sensitivity and specificity (> 0.80). Histological examination of lung tissue obtained by MIA showed characteristics of COVID-19 pneumonia, with 91% agreement with autopsy samples, and localization of SARS-CoV-2 protein in lung tissue was indicated by immunohistochemistry, with 75% agreement. These results suggest that MIA is applicable to out-of-hospital deaths of COVID-19 with a variety of postmortem changes, especially when autopsy is not available.
Keywords: COVID-19; autopsy; minimally invasive autopsy; out-of-hospital death; postmortem change.
. 2023 Jun 30.
doi: 10.7883/yoken.JJID.2023.140. Online ahead of print. Analysis of COVID-19 in tissues acquired by minimally invasive autopsy in out-of-hospital deaths with postmortem degeneration
Yuichiro Hirata 1 2 , Yohsuke Makino 2 3 , Shun Iida 1 , Harutaka Katano 1 , Sayaka Nagasawa 2 , Hirofumi Rokutan 4 , Munetoshi Hinata 4 , Akiko Iwasaki 4 , Yoichi Yasunaga 4 , Hiroyuki Abe 4 , Masako Ikemura 4 , Ayumi Motomura 2 3 5 , Kei Kira 2 3 , Susumu Kobayashi 3 , Shigeki Tsuneya 2 3 , Suguru Torimitsu 2 3 , Isao Yamamoto 6 , Kimiko Nakagawa 6 , Iwao Hasegawa 6 , Shinji Akitomi 3 7 , Daisuke Yajima 5 , Tetsuo Ushiku 4 , Hisako Saitoh 2 8 , Tadaki Suzuki 1 , Hirotaro Iwase 2 3
Affiliations
- PMID: 37394459
- DOI: 10.7883/yoken.JJID.2023.140
Minimally invasive autopsy (MIA) is an alternative to full autopsy for collection of tissue samples from patient's bodies, using an instrument such as a biopsy needle. MIA has been conducted in many cases of coronavirus disease 2019 (COVID-19) and contributed to elucidation of the pathogenesis of the disease. However, most of these cases were hospital deaths, and there are few reports on the application of MIA in out-of-hospital deaths with varying extent of postmortem changes. In this study, MIA and autopsy were both performed in 15 COVID-19 cases 2-30 days after death, including 11 out-of-hospital deaths. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome detection by reverse transcriptase quantitative polymerase chain reaction using MIA samples was mostly consistent with that using autopsy samples, especially for lung tissue, even in out-of-hospital cases. MIA had high sensitivity and specificity (> 0.80). Histological examination of lung tissue obtained by MIA showed characteristics of COVID-19 pneumonia, with 91% agreement with autopsy samples, and localization of SARS-CoV-2 protein in lung tissue was indicated by immunohistochemistry, with 75% agreement. These results suggest that MIA is applicable to out-of-hospital deaths of COVID-19 with a variety of postmortem changes, especially when autopsy is not available.
Keywords: COVID-19; autopsy; minimally invasive autopsy; out-of-hospital death; postmortem change.