Guideline Highlights Safety During Autopsy in Suspected COVID-19 Cases

By Reuters Staff

March 27, 2020

NEW YORK (Reuters Health) - The UK's Royal College of Pathologists (RCPath) has released new guidelines that emphasize risk reduction during postmortem examinations of individuals suspected of having COVID-19.

SARS-CoV-2, the virus that causes COVID-19, has been categorized as a hazard group 3 (HG3) organism which, by definition, may lead to severe human disease and can be a significant risk to employees, Dr. Brian Hanley of Imperial College London NHS Trust and colleagues note in a summary of the guidelines in the Journal of Clinical Pathology.

Conducting an autopsy on a patient with a suspected HG3 organism like SARS-CoV-2 requires attention to risk assessment, understanding of the pathology that might be found, universal standard precautions, and standard operating procedures for such pathogens.

To reduce the risks associated with SARS-CoV-2, personnel should be adequately trained in performing autopsies where HG3 organisms might be present. Adequate ventilation and personal protective equipment are vital, the authors note.

Although an isolated high-risk facility performing these autopsies is preferable, it is not compulsory, according to the guidelines.

RCPath, whose briefing for mortuary staff can be accessed at, recommends a staged postmortem "to first take the samples to assess for COVID-19 infection and only after these results have been assessed moving on to a fuller more invasive postmortem examination as required."

The appropriate authorities should be notified of any cases where COVID-19 is confirmed.

"Once appropriate precautions are in place, the risk to mortuary workers dealing with these HG3 organisms (is) slight, and a well-staffed mortuary with experienced personnel should be capable of handling cases with any of these HG3 pathogens," the authors conclude.

Dr. Hanley did not respond to a request for comments.

SOURCE: Journal of Clinical Pathology, online March 20, 2020.