No Autopsies on COVID-19 Deaths: A Missed Opportunity and the Lockdown of Science
Abstract
:1. Background
2. Methods
2.1. Database Search Terms and Timeline
2.2. Study Selection
3. Results
4. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Author | Number of Patients | Patients Who Died | Average Age (Years) | Comorbidities | Severe Complications | Tissues (Biopsy or Autopsy Samples) | Autopsy |
---|---|---|---|---|---|---|---|
Peng Y. D. et al. [8] | 112 | 17 | Data not available | Coronary heart disease (CHD) (100%), BMI >25 (88.24%) | Data not available | 0 | 0 |
Tian S. et al. [9] | 2 | 2 | 78.5 | lung cancer (100%), hypertension (100%), diabetes (50%) | Respiratory failure, coma, heart failure | 2 (biopsy) | 0 |
Guan W. J. et al. [10] | 1099 | 15 | 47 | Hypertension (15%), diabetes (7.4%), CHD (2.5%), HCV (2.1%), chronic obstructive pulmonary disease (COPD) (1.1%), cancer (0.9%) | Septic shock, acute respiratory distress syndrome (ARDS), kidney failure | 0 | 0 |
Xu Z. et al. [11] | 1 | 1 | 50 | Data not available | Respiratory failure, ARDS | 1 (autoptic sample) | 0 |
Kui K. et al. [12] | 137 | 16 | 57 | Hypertension (9.5%), diabetes (10.2%), CHD (7.3%), COPD (1.5%), cancer (1.5%) | Data not available | 0 | 0 |
Wang W. et al. [13] | 571 | 17 | 73 | Hypertension (41.2%), diabetes (23.5%), CHD (17.6%), stroke (17.6%), COPD (11.7%), kidney failure (11.7%), Parkinson (11.7%), cancer (5.9%), cirrhosis (5.9%) | Data not available | 0 | 0 |
Yang X. et al. [14] | 201 | 32 | 59.7 | CHD (9%), COPD (6%), diabetes (22%), cancer (3%), stroke (22%) | ARDS, kidney failure, heart failure, liver failure | 0 | 0 |
Huang C. et al. [15] | 41 | 6 | 49 | Diabetes (20%), hypertension (15%), cardiovascular disease (CVD) (15%) | Respiratory distress syndrome (29%), RNAaemia (15%), acute cardiac injury (12%), secondary infection (10%) | 0 | 0 |
Wang D. et al. [16] | 138 | 6 | 56 | Hypertension (31.2%), diabetes (10.1%), CVD (14.5%), Cancer (7.2%) | ARDS, arrhythmia, shock. | 0 | 0 |
Chen N. et al. [17] | 99 | 11 | 55.5 | CVD and cerebrovascular diseases (40%), digestive system disease (11%), endocrine system disease (13%), cancer (1%), nervous system disease (1%), respiratory system disease (1%) | ARDS (17%), kidney failure (3%), respiratory failure (8%), Septic shock (4%) | 0 | 0 |
Zhang et al. [18] | 7 | 5 | 59 | Not indicated | Acro-ischemia presentations including finger/toe cyanosis, skin bulla and dry gangrene (100%), definite disseminated intravascular coagulation (DIC) (4 (57%)) | 0 | 0 |
Korean Society of Infectious Diseases et al. [19] | 54 | 54 | 75.5 | CVD (59.3%); diabetes mellitus (DM) (29.6%); neurological disease (18.5%); lung disease (13.0%); malignancy (13.0%); psychologic disease (13.0%); renal disease (9.3%); hepatic disease (3.7%); kidney transplant recipient (1.9%) | Data not available | 0 | 0 |
Yuan et al. [20] | 27 | 10 | 60 | Hypertension (19%); diabetes (22%); CVD (11%); tumor (4%); cerebral infarction (4%); chronic gastritis (4%) | ARDS (41%) | 0 | 0 |
Guo et al. [21] | 187 | 43 | 58.5 | Hypertension (32.6%); CHD (11.2%); cardiomyopathy (8 (4.3%)); diabetes (15.0%); COPD (2.1); malignant neoplasm (7.0%); chronic kidney disease (CKD) (3.2%) | ARDS (24.6%), malignant arrhythmias (5.9%) including ventricular tachycardia/ventricular fibrillation, acute coagulopathy (34.1%), acute liver injury (15.4%) and acute kidney injury (14.6%) | 0 | 0 |
Yang et al. [22] | 25 | 5 | 60.2 | Hypertension (15.4%); diabetes (7.7%); COPD (38.5%); CHD (30.8%) | Data not available | 0 | 0 |
Chen et al. [23] | 274 | 113 | 62 | Hypertension (34%); diabetes (17%); CVD (8%); CHD (<1%); COPD (7%); malignancy (3%); hepatitis B (4%); cerebrovascular disease (1%); CKD (1%); gastrointestinal diseases (1%); metabolic arthritis (1%); autoimmune disease (1%) | ARDS (72%), type I respiratory failure (27%), acute cardiac injury (44%), heart failure (24%), hypoxic encephalopathy (9%), sepsis (65%), acidosis (12%), alkalosis (28%), acute kidney injury (11%), disseminated intravascular coagulation (8%), hyperkalemia (23%), shock (17%), acute liver injury (5%), gastrointestinal bleeding (<1%). | 0 | 0 |
Zhuo et al. [24] | 191 | 54 | Data not available | Data not available | Sepsis (59%), respiratory failure (54%), ARDS (31%), heart failure (23%), septic shock (20%), coagulopathy (19%), acute cardiac injury (17%), acute kidney injury (15%), secondary infection (15%), hypoproteinemia (12%), acidosis (9%) | 0 | 0 |
Deng et al. [25] | 225 | 109 | 69 | Hypertension (36.7%); lung disease (20.2%); diabetes (15.6%); heart disease (11.9%); malignancy (5.5%); others (28.4%) | ARDS (7.6%), acute cardiac injury (0.8%), acute kidney injury (<1%), shock (<1%), and disseminated intravascular coagulation (DIC) (<1%) | 0 | 0 |
Rodriguez-Morales et al. [26] | 2874 | 632 | 51.97 | Hypertension (18.6%); CVD (14.4%); diabetes (11.9%); COPD (1.8%); malignancies (2.5%); chronic liver disease (CLD) (3.0%) | 20.3% who required ICU: ARDS (32.8%), cardiac injury (13.0%), acute kidney injury (7.9%), shock (6.2%), Secondary infections (5.6%). | 0 | 0 |
Guan et al. [27] | 1590 | 50 | 48.9 | Hypertension (16.7%); CVD (53.7%), cerebrovascular disease (1.9%), diabetes (8.2%), hepatitis B (1.8%), COPD (1.5%), CKD (1.3%), malignncy (1.1%) | Data not available | 0 | 0 |
Bhatraju et al. [28] | 24 | 12 | 64 | Asthma (14%), CKD (21%), COPD (4%), tobacco smoker (22%), diabetes (58%), | Data not available | 0 | 0 |
Zhang et al. [29] | 28 | 8 | 65 | Cancer (100%), diabetes 4(14.3%), COPD 1 (3.6%) | ARDS 8 (28.6%), septic shock 1 (3.6%), suspected pulmonary embolism 2 (7.1%), AMI 1 (3.6%) | 0 | 0 |
Lescure et al. [30] | 5 | 1 | 47 | Hypertension 1 (20%), cancer 1 (20%), gout 1 (20%) | Data not available | 0 | 0 |
Wu et al. [31] | 201 | 44 | 51 | Hypertension (19.4%) diabetes (10.9%) CVD (4.0%) liver disease (3.5%) nervous system disease (3.5%) chronic lung disease (2.5%) CKD (1.0%) endocrine system disease (1.0%) tumor (0.5%) | Data not available | 0 | 0 |
Grasselli et al. [32] | 1591 | 405 | 63 | Hypertension (49%); CVD (21%); hypercholesterolemia (18%); DM (17); malignancy (8%); COPD (4%); CKD (3%); CLD (3%); other (20%) | Data not available | 0 | 0 |
Bobin et al. [33] | 10 | 4 | 68.4 | Fracture (100%); hypertension (40%); diabetes (30%); COPD (10%); osteoporosis (30%); CHD (10%); cirrhosis (10%), alzheimer disease (10%); brain injury (10%) | Data not available | 0 | 0 |
Chen et al. [34] | 203 | 26 | 54 | Hypertension (21.2%); diabetes (7.9%); CVD (7.9%); cerebrovascular disease (4.4%); malignancy (3,4%); CLD (3.9%); CKD (8 (3.9%)); COPD (8 (3.9%)); Tuberculosis (4 (2.0%)); HIV (2 (0.1%)) | Cause of Death: ARDS (14%); ARDS with MOD (22%); sepsis/Shock (4%); heart failure (2%); myocardial infarction (6%); tumor (4%); intestinal bleeding (2%); | 0 | 0 |
Li et al. [35] | 25 | 25 | 73 | Hypertension (64%); diabetes (40%); heart diseases (32%); kidney diseases (20%); cerebral infarction (16%); COPD (8%); malignant tumors (8%); acute pancreatitis (4%) | Respiratory failure (100%) | 0 | 0 |
Cao et al. [36] | 102 | 17 | 54 | Hypertension (27.5%); diabetes (10.8%); cerebrovascular disease (5.9%); CVD (4.9%); respiratory diseases (9.8%); malignancy (3.9%); CKD (3.9%); CLD (2.0%); | Shock (9.8%); ARDS (19.6%); acute infection (16.7%); acute cardiac injury (14.7%); arrhythmia (17.6%); acute kidney injury (19.6%); acute liver injury (33.3%); lymphopenia (76.5%); Cause of Death: multiple organ dysfunction syndrome (MODS) (58.8%); ARDS (5.9%); cardiac arrest (23.5%); respiratory failure (11.8%) | 0 | 0 |
Wang et al. [37] | 339 | 65 | 71 | Hypertension (40.8%), diabetes (16.0%), CVD (15.7%) | Lymphocytopenia (63.2%), bacterial infection (42.8%), liver enzyme abnormalities (28.7%), acute respiratory distress syndrome (21.0%) | 0 | 0 |
Barton et al. [38] | 2 | 2 | 77 | Hypertension, splenectomy, cholelithiasis, osteoarthritis | Cause of Death: COVID-19 (ARDS—diffuse alveolar damage (DAD)) | 0 | 2 |
42 | Myotonic, muscular dystrophy | Complications of hepatic cirrhosis (aspiration acute bacterial bronchopneumonia) | |||||
Huang et al. [39] | 2 | 2 | 54.5 | Transplantation (100%) | Nosocomial bacterial infection (100%); respiratory organ failure (100%); kidney organ failure (100%); heart organ failure (50%) | 0 | 0 |
Ling et al. [40] | 8 | 1 | 64.5 | Data not available | Respiratory failure (75%); kidney failure (25%) | 0 | 0 |
Cheng et al. [41] | 701 | 113 | 63 | Any comorbidity (42.6%); CKD (2.0%); COPD (1.9%); hypertension (33.4%); diabetes (14.3%); tumor (4.6%) | Acute kidney injury (5.1%) | 0 | 0 |
Du et al. [42] | 179 | 21 | 57.6 | Hypertension (32.4%); CVD or cerebrovascular diseases (16.2%); diabetes (18.4%); chronic digestive disorders (11.7%); tuberculosis (4.5%); chronic hepatic or renal insufficiency (2.2%); Peripheral vascular disease (2.2%); malignancy (2.2%) | Data not available | 0 | 0 |
Barrasa et al. [43] | 48 | 14 | 63 | Obesity (48%); arterial hypertension (44%); COPD (37%); | Hypoxemic respiratory failure (100%) | 0 | 0 |
Lovell et al. [44] | 101 | 75 | 82 | Hypertension (54%); diabetes (36%); dementia (31%); cancer (25%); COPD (22%); renal failure (21%); congestive heart failure (18%); stroke / neurological disorder (12%); peripheral vascular disorder (4%); liver disease (2%); | Data not available | 0 | 0 |
Wang et al. [45] | 80 | 1 | 39 | Hypertension (12.5%); diabetes (1.25%); CVD (2.5%); cerebrovascular disease (1.25%); COPD 1 (1.25%); renal disease (3.75%); liver disease (2.5%) | Data not available | 0 | 0 |
Zhang et al. [46] | 221 | 12 | 55 | Hypertension (24.4%), diabetes (10.0%), CVD (10.0%), cerebrovascular disease (6.8%), COPD (2.7%), CKD (2.7%), CLD (3.2%), malignancy (4.1%), immunosuppression treatment (1.4%) | ARDS (21.7); arrhythmia (10.9); acute cardiac injury (7.7); shock (6.8); AKI (4.5) | 0 | 0 |
Magro et al. [47] | 5 | 2 | 54.6 | Coronary artery disease, diabetes mellitus, heart failure, hepatitis C virus infection, end-stage renal disease, obesity (n = 2), and pre-diabetes, | Respiratory failure (n = 5); purpuric skin rash (n = 3) | 3 cases skin biopsies | 2 Cases, limited autopsy |
Pereira et al. [48] | 90 | 16 | 57 | HTN (64%); diabetes (46%); CKD (63%); dialysis (6%); chronic lung disease (19%); HIV (1%); active cancer (3%); BMI >40 Kg/m2 (6%) | Data not available | 0 | 0 |
Li et al. [49] | 658 | 64 | 47 | Cerebrovascular disease (8%); coronary heart disease (8.9%); heart failure (1.21%); diabetes (19.6%); hypertension (33.4%); digestive disorder (13.22%); COPD (2.88%); cancer (2.58%); CKD (2.73%); hepatitis (1.06%) | Ketosis (6.38%); acute liver injury (5.92%); septic shock (5.31%); ARDS (14.43%); diabetic ketoacidosis (DKA) (0.4%); acidosis (4.55%) | 0 | 0 |
Yang et al. [50] | 92 | 91 | 69.8 | Hypertension (55.43%); heart disease (17.39%); cerebrovascular (10.8%); malignancy (4.34%); CLD (3.26%); CKD (2.17%); COPD (1%) | Cause of death: ARDS (79.34%), septic shock (7.6%), myocardial infarction (6.52%), heart failure (2.17%), MODS (2.17%) | 0 | 0 |
Cai et al. [51] | 7 | 3 | 61 | COPD (28.5%); CVD (42.8%); interstitial lung disease (14.28%); hyperlipidemia (14.28%); Malignancy (100%) | Cause of death: respiratory failure 3 | 7 Biopsies | 0 |
Karami et al. [52] | 1 | 1 | 27 | No underlying disease | Data not available | 0 | 1 |
Tian et al. [53] | 4 | 4 | 73 | Chronic lymphocytic leukemia (CLL), cirrhosis, hypertension, diabetes, and renal transplantation | Data not available | 4 (Autopsy samples) | 0 |
Fabre et al. [54] | 1 | 1 | 45 | Obesity (BMI 40.4), hypertension | Pulmonary Embolism | 0 | 0 |
Su et al. [55] | 26 | 26 | 69 | History of hypertension or diabetes or both (42.3%) | Data not available | 26 (Kidney autopsy samples) | 0 |
Edrada et al. [56] | 2 | 2 | 42 | Data not available | Data not available | 0 | 0 |
Zhang et al. [57] | 343 | 13 | 62 | Diabetes (13.7%), hypertension (22.15%), CHD (5.5%), COPD (2.33%), cancer (2.62%), stroke history (2.33%), CLD (1.74%) | Data not available | 0 | 0 |
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Salerno, M.; Sessa, F.; Piscopo, A.; Montana, A.; Torrisi, M.; Patanè, F.; Murabito, P.; Li Volti, G.; Pomara, C. No Autopsies on COVID-19 Deaths: A Missed Opportunity and the Lockdown of Science. J. Clin. Med. 2020, 9, 1472. https://doi.org/10.3390/jcm9051472
Salerno M, Sessa F, Piscopo A, Montana A, Torrisi M, Patanè F, Murabito P, Li Volti G, Pomara C. No Autopsies on COVID-19 Deaths: A Missed Opportunity and the Lockdown of Science. Journal of Clinical Medicine. 2020; 9(5):1472. https://doi.org/10.3390/jcm9051472
Chicago/Turabian StyleSalerno, Monica, Francesco Sessa, Amalia Piscopo, Angelo Montana, Marco Torrisi, Federico Patanè, Paolo Murabito, Giovanni Li Volti, and Cristoforo Pomara. 2020. "No Autopsies on COVID-19 Deaths: A Missed Opportunity and the Lockdown of Science" Journal of Clinical Medicine 9, no. 5: 1472. https://doi.org/10.3390/jcm9051472