tetano
Editor, Senior Moderator
Clin Infect Dis
. 2021 Dec 15;73(Supplement_5):S454-S464.
doi: 10.1093/cid/ciab812.
Minimally Invasive Tissue Sampling Findings in 12 Patients With Coronavirus Disease 2019
Natalia Rakislova[SUP] 1 2 [/SUP], Maria Teresa Rodrigo-Calvo[SUP] 2 [/SUP], Lorena Marimon[SUP] 1 [/SUP], Inmaculada Ribera-Cortada[SUP] 2 [/SUP], Mamudo R Ismail[SUP] 3 4 [/SUP], Carla Carrilho[SUP] 3 4 [/SUP], Fabiola Fernandes[SUP] 3 4 [/SUP], Melania Ferrando[SUP] 1 [/SUP], Esther Sanfeliu[SUP] 2 [/SUP], Paola Castillo[SUP] 2 [/SUP], José Guerrero[SUP] 2 [/SUP], José Ramírez-Ruz[SUP] 2 [/SUP], Karmele Saez de Gordoa[SUP] 2 [/SUP], Ricardo López Del Campo[SUP] 2 [/SUP], Rosanna Bishop[SUP] 2 [/SUP], Estrella Ortiz[SUP] 2 [/SUP], Abel Muñoz-Beatove[SUP] 2 [/SUP], Jordi Vila[SUP] 1 5 [/SUP], Juan Carlos Hurtado[SUP] 1 5 [/SUP], Mireia Navarro[SUP] 5 [/SUP], Maria Maixenchs[SUP] 1 [/SUP], Vima Delgado[SUP] 1 [/SUP], Iban Aldecoa[SUP] 2 6 [/SUP], Antonio Martinez-Pozo[SUP] 2 [/SUP], Pedro Castro[SUP] 7 [/SUP], Clara Menéndez[SUP] 1 8 9 [/SUP], Quique Bassat[SUP] 1 8 10 11 9 [/SUP], Miguel J Martinez[SUP] 1 5 [/SUP], Jaume Ordi[SUP] 1 2 [/SUP]
Affiliations
Abstract
Background: Minimally invasive tissue sampling (MITS), a postmortem procedure that uses core needle biopsy samples and does not require opening the body, may be a valid alternative to complete autopsy (CA) in highly infectious diseases such as coronavirus disease-19 (COVID-19). This study aimed to (1) compare the performance of MITS and CA in a series of COVID-19 deaths and (2) evaluate the safety of the procedure.
Methods: From October 2020 to February 2021, MITS was conducted in 12 adults who tested positive before death for COVID-19, in a standard, well-ventilated autopsy room, where personnel used reinforced personal protective equipment. In 9 cases, a CA was performed after MITS. A thorough histological evaluation was conducted, and the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was evaluated by real-time reverse-transcription polymerase chain reaction (RT-PCR) and immunohistochemistry.
Results: The diagnoses provided by MITS and CA matched almost perfectly. In 9 patients, COVID-19 was in the chain of events leading to death, being responsible for diffuse alveolar damage and mononuclear T-cell inflammatory response in the lungs. No specific COVID-19 features were identified. Three deaths were not related to COVID-19. All personnel involved in MITS repeatedly tested negative for COVID-19. SARS-CoV-2 was identified by RT-PCR and immunohistochemistry in the MITS samples, particularly in the lungs.
Conclusions: MITS is useful for evaluating COVID-19-related deaths in settings where a CA is not feasible. The results of this simplified and safer technique are comparable to those of CA.
Keywords: COVID-19; MITS; SARS-CoV-2; autopsy; minimally invasive tissue sampling.
. 2021 Dec 15;73(Supplement_5):S454-S464.
doi: 10.1093/cid/ciab812.
Minimally Invasive Tissue Sampling Findings in 12 Patients With Coronavirus Disease 2019
Natalia Rakislova[SUP] 1 2 [/SUP], Maria Teresa Rodrigo-Calvo[SUP] 2 [/SUP], Lorena Marimon[SUP] 1 [/SUP], Inmaculada Ribera-Cortada[SUP] 2 [/SUP], Mamudo R Ismail[SUP] 3 4 [/SUP], Carla Carrilho[SUP] 3 4 [/SUP], Fabiola Fernandes[SUP] 3 4 [/SUP], Melania Ferrando[SUP] 1 [/SUP], Esther Sanfeliu[SUP] 2 [/SUP], Paola Castillo[SUP] 2 [/SUP], José Guerrero[SUP] 2 [/SUP], José Ramírez-Ruz[SUP] 2 [/SUP], Karmele Saez de Gordoa[SUP] 2 [/SUP], Ricardo López Del Campo[SUP] 2 [/SUP], Rosanna Bishop[SUP] 2 [/SUP], Estrella Ortiz[SUP] 2 [/SUP], Abel Muñoz-Beatove[SUP] 2 [/SUP], Jordi Vila[SUP] 1 5 [/SUP], Juan Carlos Hurtado[SUP] 1 5 [/SUP], Mireia Navarro[SUP] 5 [/SUP], Maria Maixenchs[SUP] 1 [/SUP], Vima Delgado[SUP] 1 [/SUP], Iban Aldecoa[SUP] 2 6 [/SUP], Antonio Martinez-Pozo[SUP] 2 [/SUP], Pedro Castro[SUP] 7 [/SUP], Clara Menéndez[SUP] 1 8 9 [/SUP], Quique Bassat[SUP] 1 8 10 11 9 [/SUP], Miguel J Martinez[SUP] 1 5 [/SUP], Jaume Ordi[SUP] 1 2 [/SUP]
Affiliations
- PMID: 34910166
- DOI: 10.1093/cid/ciab812
Abstract
Background: Minimally invasive tissue sampling (MITS), a postmortem procedure that uses core needle biopsy samples and does not require opening the body, may be a valid alternative to complete autopsy (CA) in highly infectious diseases such as coronavirus disease-19 (COVID-19). This study aimed to (1) compare the performance of MITS and CA in a series of COVID-19 deaths and (2) evaluate the safety of the procedure.
Methods: From October 2020 to February 2021, MITS was conducted in 12 adults who tested positive before death for COVID-19, in a standard, well-ventilated autopsy room, where personnel used reinforced personal protective equipment. In 9 cases, a CA was performed after MITS. A thorough histological evaluation was conducted, and the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was evaluated by real-time reverse-transcription polymerase chain reaction (RT-PCR) and immunohistochemistry.
Results: The diagnoses provided by MITS and CA matched almost perfectly. In 9 patients, COVID-19 was in the chain of events leading to death, being responsible for diffuse alveolar damage and mononuclear T-cell inflammatory response in the lungs. No specific COVID-19 features were identified. Three deaths were not related to COVID-19. All personnel involved in MITS repeatedly tested negative for COVID-19. SARS-CoV-2 was identified by RT-PCR and immunohistochemistry in the MITS samples, particularly in the lungs.
Conclusions: MITS is useful for evaluating COVID-19-related deaths in settings where a CA is not feasible. The results of this simplified and safer technique are comparable to those of CA.
Keywords: COVID-19; MITS; SARS-CoV-2; autopsy; minimally invasive tissue sampling.