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Tytuł pozycji:

Feasibility and safety of ultrasound-guided minimally invasive autopsy in COVID-19 patients.

Tytuł:
Feasibility and safety of ultrasound-guided minimally invasive autopsy in COVID-19 patients.
Autorzy:
Brook OR; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA. .
Piper KG; Department of Vascular Surgery, Beth Israel Deaconess Medical Center, Boston, USA.
Mercado NB; Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.
Gebre MS; Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.
Barouch DH; Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.
Busman-Sahay K; Vaccine & Gene Therapy Institute and Division of Pathobiology and Immunology, Oregon National Primate Research Center, Oregon Health & Sciences University, Beaverton, OR, 97006, USA.
Starke CE; Vaccine & Gene Therapy Institute and Division of Pathobiology and Immunology, Oregon National Primate Research Center, Oregon Health & Sciences University, Beaverton, OR, 97006, USA.
Estes JD; Vaccine & Gene Therapy Institute and Division of Pathobiology and Immunology, Oregon National Primate Research Center, Oregon Health & Sciences University, Beaverton, OR, 97006, USA.
Martinot AJ; Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.; Departments of Infectious Diseases and Global Health and Biomedical Sciences, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, 01536, USA.
Wrijil L; Departments of Infectious Diseases and Global Health and Biomedical Sciences, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, 01536, USA.
Ducat S; Departments of Infectious Diseases and Global Health and Biomedical Sciences, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, 01536, USA.
Hecht JL; Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Źródło:
Abdominal radiology (New York) [Abdom Radiol (NY)] 2021 Mar; Vol. 46 (3), pp. 1263-1271. Date of Electronic Publication: 2020 Sep 17.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Original Publication: [New York] : Springer, [2016]-
MeSH Terms:
Autopsy/*methods
COVID-19/*pathology
Ultrasonography, Interventional/*methods
Aged ; Aged, 80 and over ; Biopsy ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; SARS-CoV-2
References:
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Ledford H. Autopsy slowdown hinders quest to determine how coronavirus kills. Nature 2020. https://doi.org/10.1038/d41586-020-01355-z . (PMID: 10.1038/d41586-020-01355-z33558744)
Duarte-Neto AN, Monteiro RA de A, Johnsson J, Cunha MDP, Pour SZ, Saraiva AC, et al. Ultrasound-guided minimally invasive autopsy as a tool for rapid post-mortem diagnosis in the 2018 Sao Paulo yellow fever epidemic: Correlation with conventional autopsy. PLoS Negl Trop Dis 2019;13. https://doi.org/10.1371/journal.pntd.0007625 . (PMID: 10.1371/journal.pntd.0007625)
Fan JKM, Tong DKH, Poon JTC, Lo OS, Beh PS, Patil NG, et al. Multimodality minimally invasive autopsy-A feasible and accurate approach to post-mortem examination. Forensic Sci Int 2010;195:93–98. (PMID: 10.1016/j.forsciint.2009.11.019)
Fariña J, Millana C, Fdez-Aceñero JM, Furio V, Aragonvillo P, Martin VG, et al. Ultrasonographic autopsy (echopsy): A new autopsy technique. Virchows Arch 2002;440:635–639. (PMID: 10.1007/s00428-002-0607-z)
Maixenchs M, Anselmo R, Zielinski-Gutiérrez E, Odhiambo FO, Akello C, Ondire M, et al. Willingness to Know the Cause of Death and Hypothetical Acceptability of the Minimally Invasive Autopsy in Six Diverse African and Asian Settings: A Mixed Methods Socio-Behavioural Study. PLoS Med 2016;13. https://doi.org/10.1371/journal.pmed.1002172 .
Yao XH, Li TY, He ZC, Ping HW, Yu SC, Mou HM, et al. [A pathological report of three COVID-19 cases by minimally invasive autopsies]. Zhonghua bing li xue za zhi = Chinese J Pathol 2020;49:E009.
Bradley BT, Maioli H, Johnston R, Chaudhry I, Fink SL, Xu H, et al. Histopathology and Ultrastructural Findings of Fatal COVID-19 Infections. medRxiv 2020;:2020.04.17.20058545.
Tian S, Xiong Y, Liu H, Niu L, Guo J, Liao M, et al. Pathological study of the 2019 novel coronavirus disease (COVID-19) through postmortem core biopsies. Mod Pathol 2020. https://doi.org/10.1038/s41379-020-0536-x . (PMID: 10.1038/s41379-020-0536-x322913997156231)
Fox SE, Akmatbekov A, Harbert JL, Li G, Brown JQ, Heide RSV, et al. Pulmonary and Cardiac Pathology in Covid-19: The First Autopsy Series from New Orleans. medRxiv 2020;:2020.04.06.20050575.
Chandrashekar A, Liu J, Martinot AJ, McMahan K, Mercado NB, Peter L, et al. SARS-CoV-2 infection protects against rechallenge in rhesus macaques. Science (80-) 2020;:eabc4776.
Deleage C, Wietgrefe SW, Del Prete G, Morcock DR, Hao XP, Piatak Jr M, et al. Defining HIV and SIV Reservoirs in Lymphoid Tissues. Pathog Immun 2016;1:68. (PMID: 10.20411/pai.v1i1.100)
Wölfel R, Corman VM, Guggemos W, Seilmaier M, Zange S, Muller MA, et al. Virological assessment of hospitalized patients with COVID-2019. Nature 2020;581:465–469. (PMID: 10.1038/s41586-020-2196-x)
Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, laenger F, et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med 2020;:NEJMoa2015432.
Van Der Linden A, Blokker BM, Kap M, Weustnik AC, Robertus JL, Riegman PH, et al. Post-mortem tissue biopsies obtained at minimally invasive autopsy: An RNA-quality analysis. PLoS One 2014;9. https://doi.org/10.1371/journal.pone.0115675 .
Castillo P, Martínez MJ, Ussene E, Jordao D, Lovane L, Ismail MR, et al. Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study. PLoS Med 2016;13. https://doi.org/10.1371/journal.pmed.1002171 .
Martínez MJ, Massora S, Mandomando I, Ussene E, Jordao D, Lovane L, et al. Infectious cause of death determination using minimally invasive autopsies in developing countries. Diagn Microbiol Infect Dis 2016;84:80–86. (PMID: 10.1016/j.diagmicrobio.2015.10.002)
Batlle D, Soler MJ, Sparks MA, Hiremath S, South AM, Welling PA, et al. Acute Kidney Injury in COVID-19: Emerging Evidence of a Distinct Pathophysiology. J Am Soc Nephrol 2020. https://doi.org/10.1681/asn.2020040419 . (PMID: 10.1681/ASN.202004041932669323)
Grant Information:
K08 AI135098 United States AI NIAID NIH HHS
Contributed Indexing:
Keywords: Autopsy; Biopsy; COVID-19
Entry Date(s):
Date Created: 20200917 Date Completed: 20210329 Latest Revision: 20210714
Update Code:
20240104
PubMed Central ID:
PMC7494380
DOI:
10.1007/s00261-020-02753-7
PMID:
32939636
Czasopismo naukowe
Objectives: To determine the feasibility and safety of ultrasound-guided minimally invasive autopsy in COVID-19 patients.
Methods: 60 patients who expired between 04/22/2020-05/06/2020 due to COVID-19 were considered for inclusion in the study, based on availability of study staff. Minimally invasive ultrasound-guided autopsy was performed with 14G core biopsies through a 13G coaxial needle. The protocol required 20 cores of the liver, 30 of lung, 12 of spleen, 20 of heart, 20 of kidney, 4 of breast, 4 of testis, 2 of skeletal muscle, and 4 of fat with total of 112 cores per patient. Quality of the samples was evaluated by number, size, histology, immunohistochemistry, and in situ hybridization for COVID-19 and PCR-measured viral loads for SARS-CoV-2.
Results: Five (5/60, 8%) patients were included. All approached families gave their consent for the minimally invasive autopsy. All organs for biopsy were successfully targeted with ultrasound guidance obtaining all required samples, apart from 2 patients where renal samples were not obtained due to atrophic kidneys. The number, size, and weight of the tissue cores met expectation of the research group and tissue histology quality was excellent. Pathology findings were concordant with previously reported autopsy findings for COVID-19. Highest SARS-CoV-2 viral load was detected in the lung, liver, and spleen that had small to moderate amount, and low viral load in was detected in the heart in 2/5 (40%). No virus was detected in the kidney (0/3, 0%).
Conclusions: Ultrasound-guided percutaneous post-mortem core biopsies can safely provide adequate tissue. Highest SARS-CoV-2 viral load was seen in the lung, followed by liver and spleen with small amount in the myocardium.

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