학술논문
Minimally Invasive Tissue Sampling Findings in 12 Patients With Coronavirus Disease 2019.
Document Type
Article
Author
Rakislova, Natalia; Rodrigo-Calvo, Maria Teresa; Marimon, Lorena; Ribera-Cortada, Inmaculada; Ismail, Mamudo R; Carrilho, Carla; Fernandes, Fabiola; Ferrando, Melania; Sanfeliu, Esther; Castillo, Paola; Guerrero, José; Ramírez-Ruz, José; Gordoa, Karmele Saez de; Campo, Ricardo López Del; Bishop, Rosanna; Ortiz, Estrella; Muñoz-Beatove, Abel; Vila, Jordi; Hurtado, Juan Carlos; Navarro, Mireia
Source
Subject
*CROSS infection prevention
*TISSUE analysis
*SAFETY
*PULMONARY alveoli
*COVID-19
*MONONUCLEAR leukocytes
*ENDOSCOPIC surgery
*AUTOPSY
*IMMUNOHISTOCHEMISTRY
*INFLAMMATION
*DEATH
*COVID-19 testing
*PERSONAL protective equipment
*HISTOLOGY
*POLYMERASE chain reaction
*T cells
*NEEDLE biopsy
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Language
ISSN
1058-4838
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. [ABSTRACT FROM AUTHOR]