Potentials of post-mortem CT investigations during SARS-COV-2 pandemic: a narrative review

• Published in: Radiologia medica 2022-04, Vol.127 (4), p.383-390
• Main Authors: Filograna, Laura, Manenti, Guglielmo, Ampanozi, Garyfalia, Calcagni, Antonello, Ryan, Colleen Patricia, Floris, Roberto, Thali, Michael John
• Format: Article
• Language: English
• Subjects: Autopsies; Autopsy - methods; Computed Tomography; Coronaviruses; COVID-19; Diagnostic Radiology; Humans; Imaging; Infections; Interventional Radiology; Medical imaging; Medicine; Medicine & Public Health; Neuroradiology; Pandemics; Radiology; SARS-CoV-2; Screening; Searching; Severe acute respiratory syndrome coronavirus 2; Tomography, X-Ray Computed - methods; Ultrasound; Viral diseases
• ISSN: 1826-6983; 0033-8362; 1826-6983
• DOI: 10.1007/s11547-022-01457-w

In December 2019, a new coronavirus, SARS-COV-2, caused a cluster of cases of pneumonia in China, and rapidly spread across the globe. It was declared a pandemic by the World Health Organization on March 11th, 2020. Virtual autopsy by post-mortem CT (PMCT) and its ancillary techniques are currently applied in post-mortem examinations as minimally or non-invasive techniques with promising results. In this narrative review, we speculate on the potentials of PMCT and its ancillary techniques, as a viable investigation technique for analysis of suspected or confirmed SARS-COV-2 deaths. An online literature search was performed by using three prefix search terms (postmortem, post-mortem, post mortem) individually combined with the suffix radiology, imaging, computed tomography, CT and with the search terms ‘SARS-CoV-2’ and ‘COVID-19’ to identify papers about PMCT and its ancillary techniques in SARS-COV-2 positive cadavers. PMCT findings suggestive for pulmonary COVID-19 in deceased positive SARS-COV-2 infection are reported in the literature. PMCT ancillary techniques were never applied in such cases. PMCT imaging of the lungs has been proposed as a pre-autopsy screening method for SARS-COV-2 infection. Further studies are needed to ascertain the value of PMCT in determining COVID-19 as the cause of death without autopsy histopathological confirmation. We advocate the application of PMCT techniques in the study of ascertained or suspected SARS-COV-2 infected deceased individuals as a screening technique and as a method of post-mortem investigation, to augment the numbers of case examined and significantly reducing infection risk for the operators.