Forensic Medicine Practice In The Time Of COVID-19 Pandemic: Challenges And Future Perspectives (original) (raw)
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A roadmap to the safe practice of forensic medicine in the COVID-19 pandemic
Journal of Forensic and Legal Medicine, 2020
The COVID-19 pandemic has forced forensic practitioners to consider how we perform our normal duties, especially when those duties involve humans. The potential for contracting the virus from working in close contact with living sufferers is high, and we have yet to fully determine the risk of infection from the deceased. In an attempt to support the community, the Journal of Forensic & Legal Medicine has drawn together three articles which underline the importance of continued forensic medical practice during the pandemic and highlight some factors to consider in a Roadmap towards safe practice. Our Roadmap has intentionally taken an international perspective and supports other work we have published in the Journal on our collective response to the COVID-19 crisis.
Forensic Pathology and Legal Issues in COVID-19: Case Report and Literature Review
Curēus, 2024
Autopsy investigations of deaths following nosocomial coronavirus disease 2019 (COVID-19) infection have enormous medical and social significance, as autopsies are essential for the correct statistical recording of COVID-19 deaths, presenting new lessons, which is important to policymakers and in the improvement of public health in general. Our study is based on the presentation of a case of a road traffic accident involving an elderly 73-year-old female with a complication of nosocomial COVID-19 infection and death leading to forensic pathological investigation. This involved autopsy, histopathological examinations, and other tests, and highlighting the importance of medicolegal matters, including the legal and ethical practicalities encountered in healthcare. This article highlights the fact that patients who have sustained various traumatic injuries accompanied by nosocomial COVID-19 infection have higher risks of morbidity and mortality. The significance of the role of a Forensic Pathologist in dealing with the analysis of injuries and the performance of autopsies to determine the cause, mechanism, and manner of death. In addition, the important lesson of testing patients for COVID-19 more regularly during a long hospital admission period, to offer early treatment and isolation, including avoiding the further spread of the COVID-19 infection variants to patients and healthcare professionals, thereby minimising and preventing hospital-acquired infection and death is stressed.
MARKS OF THE COVID-19 PANDEMIC ON FORENSIC MEDICINE: A SYSTEMATIC REVIEW
Rom J Leg Med
Since the end of 2019, humanity has been facing a pandemic generated by the SARS-COV-2 virus, which is felt in most functioning domains. Thus, the goal is to see how much forensic medicine has been affected by this virus and how it has reacted to this pandemic, given the fact that this domain can be of key importance in the fight against COVID-19. A number of 7 articles that met the inclusion and exclusion criteria were thus analysed, initially starting from a number of 414 articles of so, searched in the PubMed database. The analysis of the specialized literature shows us that the number of autopsies performed, as well as of the publications in this sense is a low one.
Journal of Forensic and Legal Medicine
, health authorities in the People's Republic of China informed the World Health Organization of a then limited outbreak of interstitial viral pneumonia, identified at a laboratory in the city of Wuhan. In mid-April 2020 this outbreak of COVID-19 (as the disease has been called) has aggravated and spread worldwide, causing more than 200,000 deaths and affecting especially the United States, Spain, Italy, France and the United Kingdom. Despite the severity of the outbreak, the pathological findings have not been described in detail and there are very few guidelines or protocols for conducting autopsy studies on patients who have died from COVID-19. There are currently very few histopathological case series studies on this disease. In addition, some of these studies have been performed on biopsies or surgical resection pieces from patients in whom disease was subsequently demonstrated or through minimally invasive autopsy protocols. None of the studies offer a detailed necropsy protocol. This document proposes a protocol of action for the institutes of Forensic Medicine facing the current SARS-CoV2 pandemic, which combines protection of worker safety with optimization of tissue collection.
Mediscope
WHO declared COVID-19 a global pandemic on 11th March, 2020. The heightened fear regarding COVID-19 is a result of many things. It is a new pathogen with some unknown characteristics, and misinformation is all over the news and social media. In this pandemic situation, to combat any known or unknown biohazard risk associated with medicolegal autopsy, handling autopsy specimens, each section of the diagnostic procedure and laboratory processes have some specific guidelines for handling infectious agents like spread of SARS-CoV-2 that convey excessive risk for exposure and possible infection and/or occupational injury. These risks typically are associated with design flaws or lack of or inadequacy of safety procedures and training. However, we still lack a concrete guideline in our country on medicolegal autopsy, collection and submission of postmortem specimens from deceased persons with known or suspected covid-19 cases during this pandemic situation. This review aims to provide som...
Safe Management Strategies in Clinical Forensic Autopsies of Confirmed COVID-19 Cases
Diagnostics
To date, there is poor evidence on the transmission of infection in individuals handling the bodies of deceased persons infected with SARS-CoV-2 and in particular, during autopsies. The aim of this study was to demonstrate that when appropriate strategies are adopted autopsy is a safe procedure with a minimal infection risk for all subjects involved (pathologists, technical personnel, and others) when proper strategies are adopted. We performed 16 autopsies on cadavers of persons who had died with confirmed COVID-19 with different post-mortem intervals (PMI). To confirm the presence of SARS-CoV-2 RNA, for each autopsy, 2 swabs were sampled from lungs, while to evaluate environmental contamination, 11 swabs were taken at three different times: T0 (before autopsy), T1 (at the end of the autopsy, without removing the corpse), and T2 (after cleaning and disinfecting the autopsy room). Specifically, 2 swabs were sampled on face shields used by each pathologist, and 4 swabs were collected...
Clinical-Forensic Autopsy Findings to Defeat COVID-19 Disease: A Literature Review
Journal of Clinical Medicine
The severe acute respiratory syndrome (SARS)-CoV-2 was identified for the first time in China, in December 2019. Confirmed cases of COVID-19 have been reported around the world; indeed, this infection has been declared a pandemic. Consequently, the scientific community is working hard to gain useful information about the history of this virus, its transmission, diagnosis, clinical features, radiological findings, research and development of candidate therapeutics as well as vaccines. This review aims to analyze the diagnostic techniques used to ascertain the COVID-19 infection, critically reviewing positive points and criticism for forensic implications, obviously including autopsy. Finally, this review proposes a practical workflow to be applied in the management of corpses during this outbreak of the COVID-19 infection, which could be useful in cases of future infectious disease emergencies. Analyzing the diagnostic methods, to date, virus nucleic acid RT-PCR represents the standa...
Impact of the COVID-19 Pandemic on Forensic Medicine Residency Training
Adli tıp bülteni, 2022
This paper aims to assess the impact of severe acute respiratory syndrome coronavirus 2 outbreak on forensic medicine residency training and to reveal implemented methods to keep the standard of residency education to prevent pandemic's catastrophic effects on education of forensic medicine residents in Turkey. Methods: Two online-based surveys were prepared towards "Residents of forensic medicine" and "Head of departments". Survey-1 completed by 125 forensic medicine residents and Survey-2 completed by 18 heads of forensic medicine departments from different regions of Turkey. Results: More than half of the residents who started their clinical training practice before outbreak of pandemic reported that there has been a decrease in numbers of clinical practical activities, and half of the residents stated that lectures/meetings have been suspended due to the pandemic. Distance learning/meeting applications in educational activities were found "partially useful" or "useful" by 83.2% of the residents (n=104). Residents who pointed out a change in practical autopsy training reported that this change has negatively affected their forensic medicine residency training. Conclusion: Sharing our results might force potential implementations to prevent worsening and improve forensic medicine residency training here and worldwide to identify effective responses to such unexpected issues.
Safety Recommendations for Forensic Laboratory Staff During COVID-19 Pandemic
Academic Forensic Pathology
In the 21st century, the crime rate and viral infectious diseases are on peak and seems to be the real enemies of humanity. Forensic science and its various branches especially biology have a key role in modern-day justice. Forensic scientists and laboratory staffs are of great significance for elucidating the biological exhibits and generating the biological evidence which are required for criminal justice. Owing to the profession and like other medical health workers, forensic laboratory staffs are also at a greater risk in the era of COVID-19. Therefore, the safety of forensic laboratory staff is of utmost importance during this pandemic. The article emphasizes on the safety guidelines and regulations that need to be adopted by the forensic staff in connection with daily laboratory practices. Thus, the article may offer a reference or help one to implement COVID-19 advisory to forensic scientists and other laboratory staff working in forensic institutions and laboratories during ...
Survey on postmortem screening and management of COVID-19 related deaths
Pathologica, 2021
The COVID-19 pandemic is associated with a high case fatality rate in some countries even thought the majority of cases are asymptomatic. Scientific studies on this novel virus is limited and there is uncertainty regarding the best practices for death investigations both in terms of detection of the disease as well as autopsy safety. An online survey was conducted to identify how different institutions responded to the screening and management of dead bodies during the early phase of the pandemic from January to May. A questionnaire was developed using Google Forms and data was collected from 14 different forensic and pathological institutions in 9 countries. None of the institutions had performed any screening prior to March. Four institutions stated that screening was done routinely. In total, 322 cases had been screened using RT-PCR, out of which 40 positive cases were detected among four institutions. The commonest types of samples obtained were nasopharyngeal and oropharyngeal swabs which also had the highest rates of positivity followed by tracheal swab. Blood, swabs from cut surfaces of lung and lung tissue also gave positive results in some cases. Majority of the positive cases were > 65 years with a history suggestive of respiratory infection and were clinically suspected to have COVID-19 before death. Except for one institution which performed limited dissections, standard autopsies were conducted on all positive cases. Disposal of bodies involved the use of sealed body bags and labelling as COVID positive. Funeral rites were restricted and none of the institutions advocated cremation. There were no reports of disease transmission to those who handled COVID positive bodies.