Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Dec 15;10(24):5876.
doi: 10.3390/jcm10245876.

Autopsy Findings and Causality Relationship between Death and COVID-19 Vaccination: A Systematic Review

Francesco Sessa  1 , Monica Salerno  2 , Massimiliano Esposito  2 , Nunzio Di Nunno  3 , Paolo Zamboni  4 , Cristoforo Pomara  2
Affiliations
Review

Autopsy Findings and Causality Relationship between Death and COVID-19 Vaccination: A Systematic Review

Francesco Sessa et al. J Clin Med. .

Abstract

The current challenge worldwide is the administration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. Considering that the COVID-19 vaccination represents the best possibility to resolve this pandemic, this systematic review aims to clarify the major aspects of fatal adverse effects related to COVID-19 vaccines, with the goal of advancing our knowledge, supporting decisions, or suggesting changes in policies at local, regional, and global levels. Moreover, this review aims to provide key recommendations to improve awareness of vaccine safety. All studies published up to 2 December 2021 were searched using the following keywords: "COVID-19 Vaccine", "SARS-CoV-2 Vaccine", "COVID-19 Vaccination", "SARS-CoV-2 Vaccination", and "Autopsy" or "Post-mortem". We included 17 papers published with fatal cases with post-mortem investigations. A total of 38 cases were analyzed: 22 cases were related to ChAdOx1 nCoV-19 administration, 10 cases to BNT162b2, 4 cases to mRNA-1273, and 2 cases to Ad26.COV2.S. Based on these data, autopsy is very useful to define the main characteristics of the so-called vaccine-induced immune thrombotic thrombocytopenia (VITT) after ChAdOx1 nCoV-19 vaccination: recurrent findings were intracranial hemorrhage and diffused microthrombi located in multiple areas. Moreover, it is fundamental to provide evidence about myocarditis related to the BNT162B2 vaccine. Finally, based on the discussed data, we suggest several key recommendations to improve awareness of vaccine safety.

Keywords: COVID-19 vaccination; adverse events following immunization (AEFI); fatal case; vaccine-induced immune thrombotic thrombocytopenia (VITT).

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the literature search and study selection for this systematic review (PRISMA flow chart).
Figure 2
Figure 2
Box plot analysis comparing the age of subjects involved in fatal cases after vaccine administration (A). Comparison of the time interval between vaccine administration and the first symptoms (B).
See this image and copyright information in PMC

References

    1. Gorbalenya A.E., Baker S.C., Baric R.S., de Groot R.J., Drosten C., Gulyaeva A.A., Haagmans B.L., Lauber C., Leontovich A.M., Neuman B.W., et al. The species Severe acute respiratory syndrome-related coronavirus: Classifying 2019-nCoV and naming it SARS-CoV-2. Nat. Microbiol. 2020;5:536–544. - PMC - PubMed
    1. Wordometers Info COVID-19 Coronavirus Pandemic—Wordometer. [(accessed on 2 December 2021)]. Available online: https://www.worldometers.info/coronavirus/
    1. Josh Holder Tracking Coronavirus Vaccinations Around the World. [(accessed on 2 December 2021)]. Available online: https://www.nytimes.com/interactive/2021/world/COVID-vaccinations-tracke....
    1. Mallapaty S. India’s DNA COVID vaccine is a world first—More are coming. Nature. 2021;597:161–162. doi: 10.1038/d41586-021-02385-x. - DOI - PubMed
    1. Edwards K., Orenstein W. COVID-19: Vaccines to Prevent SARS-CoV-2 Infection. [(accessed on 2 December 2021)]. Available online: https://www.uptodate.com/contents/COVID-19-vaccines-to-prevent-SARS-CoV-....

LinkOut - more resources