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COVID-19 Autopsies, Oklahoma, USA.
Am J Clin Pathol. 2020 05 05; 153(6):725-733.AJ

Abstract

OBJECTIVES

To report the methods and findings of two complete autopsies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive individuals who died in Oklahoma (United States) in March 2020.

METHODS

Complete postmortem examinations were performed according to standard procedures in a negative-pressure autopsy suite/isolation room using personal protective equipment, including N95 masks, eye protection, and gowns. The diagnosis of coronavirus disease 2019 (COVID-19) was confirmed by real-time reverse transcriptase polymerase chain reaction testing on postmortem swabs.

RESULTS

A 77-year-old obese man with a history of hypertension, splenectomy, and 6 days of fever and chills died while being transported for medical care. He tested positive for SARS-CoV-2 on postmortem nasopharyngeal and lung parenchymal swabs. Autopsy revealed diffuse alveolar damage and chronic inflammation and edema in the bronchial mucosa. A 42-year-old obese man with a history of myotonic dystrophy developed abdominal pain followed by fever, shortness of breath, and cough. Postmortem nasopharyngeal swab was positive for SARS-CoV-2; lung parenchymal swabs were negative. Autopsy showed acute bronchopneumonia with evidence of aspiration. Neither autopsy revealed viral inclusions, mucus plugging in airways, eosinophils, or myocarditis.

CONCLUSIONS

SARS-CoV-2 testing can be performed at autopsy. Autopsy findings such as diffuse alveolar damage and airway inflammation reflect true virus-related pathology; other findings represent superimposed or unrelated processes.

Authors+Show Affiliations

Office of the Chief Medical Examiner, Oklahoma City, OK.Office of the Chief Medical Examiner, Oklahoma City, OK.Office of the Chief Medical Examiner, Oklahoma City, OK.Section of Thoracic Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH.Department of Pathology, Cleveland Clinic, Cleveland, OH.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

32275742

Citation

Barton, Lisa M., et al. "COVID-19 Autopsies, Oklahoma, USA." American Journal of Clinical Pathology, vol. 153, no. 6, 2020, pp. 725-733.
Barton LM, Duval EJ, Stroberg E, et al. COVID-19 Autopsies, Oklahoma, USA. Am J Clin Pathol. 2020;153(6):725-733.
Barton, L. M., Duval, E. J., Stroberg, E., Ghosh, S., & Mukhopadhyay, S. (2020). COVID-19 Autopsies, Oklahoma, USA. American Journal of Clinical Pathology, 153(6), 725-733. https://doi.org/10.1093/ajcp/aqaa062
Barton LM, et al. COVID-19 Autopsies, Oklahoma, USA. Am J Clin Pathol. 2020 05 5;153(6):725-733. PubMed PMID: 32275742.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - COVID-19 Autopsies, Oklahoma, USA. AU - Barton,Lisa M, AU - Duval,Eric J, AU - Stroberg,Edana, AU - Ghosh,Subha, AU - Mukhopadhyay,Sanjay, PY - 2020/4/11/pubmed PY - 2020/5/8/medline PY - 2020/4/11/entrez KW - Acute lung injury KW - Autopsy KW - COVID-19 KW - Coronavirus KW - Diffuse alveolar damage KW - Pulmonary pathology KW - SARS-CoV-2 SP - 725 EP - 733 JF - American journal of clinical pathology JO - Am J Clin Pathol VL - 153 IS - 6 N2 - OBJECTIVES: To report the methods and findings of two complete autopsies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive individuals who died in Oklahoma (United States) in March 2020. METHODS: Complete postmortem examinations were performed according to standard procedures in a negative-pressure autopsy suite/isolation room using personal protective equipment, including N95 masks, eye protection, and gowns. The diagnosis of coronavirus disease 2019 (COVID-19) was confirmed by real-time reverse transcriptase polymerase chain reaction testing on postmortem swabs. RESULTS: A 77-year-old obese man with a history of hypertension, splenectomy, and 6 days of fever and chills died while being transported for medical care. He tested positive for SARS-CoV-2 on postmortem nasopharyngeal and lung parenchymal swabs. Autopsy revealed diffuse alveolar damage and chronic inflammation and edema in the bronchial mucosa. A 42-year-old obese man with a history of myotonic dystrophy developed abdominal pain followed by fever, shortness of breath, and cough. Postmortem nasopharyngeal swab was positive for SARS-CoV-2; lung parenchymal swabs were negative. Autopsy showed acute bronchopneumonia with evidence of aspiration. Neither autopsy revealed viral inclusions, mucus plugging in airways, eosinophils, or myocarditis. CONCLUSIONS: SARS-CoV-2 testing can be performed at autopsy. Autopsy findings such as diffuse alveolar damage and airway inflammation reflect true virus-related pathology; other findings represent superimposed or unrelated processes. SN - 1943-7722 UR - https://www.unboundmedicine.com/medline/citation/32275742/COVID-19_Autopsies,_Oklahoma,_USA L2 - https://academic.oup.com/ajcp/article-lookup/doi/10.1093/ajcp/aqaa062 DB - PRIME DP - Unbound Medicine ER -