Use of Post-Mortem Computed Tomography During the COVID-19 Pandemic: The Malaysian Experience

COVID-19 was declared a pandemic by the World Health Organization (WHO). COVID-19 is highly contagious, making it a threat to healthcare workers, including those working in mortuaries. Therefore, it is important to determine if the cause of death (COD) could be identified using limited autopsy, diag...

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Bibliographic Details
Published in:The Malaysian journal of medical sciences 2022-10, Vol.29 (5), p.83-92
Main Authors: Chainchel Singh, Mansharan Kaur, Mohd Noor, Mohamad Helmee, Ibrahim, Mohamad Azaini, Siew, Sheue Feng, Lai, Poh Soon
Format: Article
Language:English
Subjects:
Abdomen
Autopsies
Coronaviruses
COVID-19
COVID-19 diagnostic tests
Disease transmission
Emergency medical care
Forensic pathology
Health care
Infections
Laboratories
Medical personnel
Medical supplies
Original
Pandemics
Pathogens
Pneumonia
Polymerase chain reaction
Respiratory diseases
Severe acute respiratory syndrome coronavirus 2
Tomography
Viruses
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Summary:COVID-19 was declared a pandemic by the World Health Organization (WHO). COVID-19 is highly contagious, making it a threat to healthcare workers, including those working in mortuaries. Therefore, it is important to determine if the cause of death (COD) could be identified using limited autopsy, diagnostic tests and post-mortem imaging modalities instead of full autopsy. This study aims to examine the effectiveness of post-mortem imaging, specifically post-mortem computed tomography (PMCT) at determining the COD during a pandemic. This cross-sectional study included 172 subjects with suspected or unknown COVID-19 status brought in dead to the institute's mortuary during the pandemic in Malaysia. PMCT images reported by forensic radiologists and their agreement with conventional autopsy findings by forensic pathologists regarding COD were analysed to look at the effectiveness of PMCT in determining COD during a pandemic. Analysis showed that 78.7% (133) of cases reported by forensic radiologists concurred with the COD certified by forensic pathologists. Of these cases, 85 (63.9%) had undergone only external examination and real-time reverse transcriptase polymerase chain reaction (rRT-PCR) COVID-19 testing, meaning that imaging was the sole method used to determine the COD besides history from available medical records and the investigating police officer. PMCT can be used as a complement to medicolegal autopsies in pandemic contexts, as it provides significant information on the possible COD without jeopardising the safety of mortuary health care workers.
ISSN:1394-195X
2180-4303
DOI:10.21315/mjms2022.29.5.9