Minimally Invasive Autopsy: a more feasible and safer alternative to conventional autopsy in the COVID-19 pandemic era?

Abstract

Robust evidence on the pathogenesis and pathological findings of most diseases is based on autopsy examination. In view of the many knowledge gaps still hindering our current understanding of SARSCoV-2 infection, post-mortem studies in this life-threatening disease are urgently needed. However, due to logistic and especially biohazard challenges less than 50 post-mortem examinations have been conducted in patients dying from COVID-19; most of them adult males with comorbidities. A few years ago, our group developed and validated in all age-groups a standardised minimally invasive autopsy (MIA) protocol, which might be a safer and more feasible approach to investigate SARS-CoV-2-related deaths. This MIA method is highly accurate in exploring infection-related deaths and may represent a valid post-mortem approach in all settings during the COVID-19 pandemic, especially in those lacking adequate facilities to perform high-risk autopsies. Expansion in the use of MIA might contribute to eliminate the current knowledge gaps on the COVID-19 disease, especially in pediatric deaths and in cases with unusual clinical features.