Rationale In a very short time corona virus disease 2019 (COVID-19) has become a pandemicwith high morbidity and mortality. The main cause of death is respiratory failureincluding acute respiratory distress syndrome, however the exact mechanisms and otherunderlying pathology is currently not yet known. In the current setting of the COVID-19pandemic complete autopsies seem too risky due to the risk of SARS CoV-2 transmission.Yet, as so little is known, additional histopathological, microbiological and virologicstudy of tissue of deceased COVID-19 patients will provide important clinical andpathophysiological information. Minimal invasive autopsy combined with postmortem imagingseems therefore an optimal method combining safety on the one hand yet provingsignificant information on the other.This study aims to determine the cause of death and attributable conditions in deceasedCOVID-19 patients. This will be performed using post-mortem CT-scanning plus CT-guidedMIA to obtain tissue for further histological, microbiological and pathologicaldiagnostics. In addition, the pathophysiology of COVID-19 will be examined by furthertissue analysis.
Procedure: CT-scan with minimal invasive autopsy
CT-guided biopsies will be performed directly following the diagnostic CT-scan. Biopsies
will be taken from heart, liver, lungs, spleen, kidneys and abdominal fat according to a
standard operation procedure. Biopsies will be taken for further histological examination
and storage in the biobank. Of the lung, additional samples will be taken for
microbiological examination. Additional samples will be taken in case of (focal)
abnormalities on CT-imaging. In case of pleural, cardiac or abdominal fluid, this will be
aspirated for further cytological, biochemical and microbiological examination. Finally,
15 cc blood will be drawn from the heart.
Inclusion Criteria:
- All patients with COVID-19 that die during hospitalization in Jessa hospital.
COVID-19 is defined as either a positive SARS CoV-2 PCR result OR a high clinical
suspicion combined with typical radiologic findings in the absence of an alternative
explanation for the clinical picture.
Exclusion Criteria:
- None
Jessa Hospital
Hasselt, Belgium
Janneke Cox, MD, PhD, Principal Investigator
Jessa Hospital