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. 2021;31(2):145-147.
doi: 10.1007/s00194-021-00462-z. Epub 2021 Feb 15.

COVID-19 lungs in post-mortem computed tomography

I Kniep  1 , A Heinemann  1 , C Edler  1 , J P Sperhake  1 , K Püschel  1 , B Ondruschka  1 , A S Schröder  1
Affiliations

COVID-19 lungs in post-mortem computed tomography

I Kniep et al. Rechtsmedizin (Berl). 2021.

Abstract
in English, German

Post-mortem computed tomography (PMCT) is a rapid and noninvasive diagnostic tool for important contributions to the identification of pulmonary findings in the deceased with pneumonia, including cases of coronavirus disease 2019 (COVID-19). Although computed tomography (CT) shows a high sensitivity for pneumonia in living persons, it is relatively unspecific for COVID-19 pneumonia clinically. Typical CT findings for viral pneumonia therefore require confirmation by PCR tests (polymerase chain reaction tests), even if lung infections with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) show characteristic patterns, most frequently ground glass opacities (GGO) and a combination of GGO and air space consolidations. In the consecutive autopsy series of SARS-CoV‑2 deaths from Hamburg, Germany, the most frequent cause of death was and still is COVID-19 pneumonia. Typical findings were frequently found in the PMCT in SARS-CoV-2-associated deaths, which were taken into account when classifying the death as COVID-19.

Die Post-mortem-Computertomographie (PMCT) ist ein schnelles und nicht-invasives Diagnoseinstrument, das einen wichtigen Beitrag zur Identifizierung von Lungenbefunden bei Verstorbenen mit Pneumonie leistet – auch bei Fällen der Coronaviruskrankheit (COVID -19). Obwohl die Computertomografie (CT) eine hohe Sensitivität für Lungenentzündungen bei lebenden Personen aufweist, ist sie für eine COVID-19-Pneumonie klinisch recht unspezifisch. Typische CT-Befunde für virale Pneumonien bedürfen daher der Bestätigung durch PCR-Tests (Polymerase-Ketten-Reaktion-Tests), auch wenn die Lungeninfektion mit SARS-CoV‑2 charakteristische Muster zeigt – am häufigsten Milchglastrübungen (GGO) und eine Kombination aus GGO und Konsolidierungen.In der konsekutiven Autopsieserie von SARS-CoV-2-Todesfällen aus Hamburg war und ist die häufigste Todesursache die COVID-19-Pneumonie. In der PMCT fanden sich bei SARS-CoV-2-assoziierten Todesfällen häufig typische Befunde, die bei der Klassifizierung des Todes als COVID-19 berücksichtigt wurden.

Keywords: Consolidation; Ground glass opacities; Hypostasis; Pulmonary manifestation; SARS-CoV-2.

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Conflict of interest statement

Conflict of interestI. Kniep, A. Heinemann, C. Edler, J.P. Sperhake, K. Püschel, B. Ondruschka and A.S. Schröder declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Post-mortem computed tomography case 1. a Axial CT image (lung section). b Coronary CT image (lung section)
Fig. 2
Fig. 2
Post-mortem computed tomography case 2. a Axial CT image (lung section; blue arrow directing to the area of consolidation). b Coronary CT image (lung section)
Fig. 3
Fig. 3
Post-mortem computed tomography case 3. a Axial CT image (section of the lung). b Coronary CT image (lung section)
See this image and copyright information in PMC

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