Forensic Autopsy-Confirmed COVID-19-Induced Out-of-Hospital Cardiac Arrest: Case Report

Case Report

Volume 3, Issue 4 (April Issue)

Forensic Autopsy-Confirmed COVID-19-Induced Out-of-Hospital Cardiac Arrest: Case Report

Laurent Fanton^1,2*, Isabelle Nahmani^1,2*, Marie Epain¹, Anne-Sophie Advenier¹, Martin Cour^2,3, David Meyronet^2,4 and Laurent Argaud^2,3

¹Hospice Civils de Lyon, Hôpital Edouard Herriot, Service de Médecine Légale, Hôpital Edouard Herriot, Lyon, France
²Université de Lyon, Université Claude-Bernard Lyon, Faculté de Médecine Lyon-Est, Lyon, France
³Hospice Civils de Lyon, Hôpital Edouard Herriot, Service de Médecine Intensive-Réanimation, Hôpital Edouard Herriot, Lyon, France
⁴Hospices Civils de Lyon, Service d’Anatomo-Pathologie, Hôpital Femmes-Mères-Enfants, Bron, France

^*Corresponding author: Pr. Laurent Fanton, Service de Médecine Légale, Hôpital Edouard Herriot, 5, Place d’Arsonval, 69437 Lyon Cedex 03, France, Tel: (+33)-4-72-11-01-17; E-mail: laurent.fanton@chu-lyon.fr

Received: April 20, 2021; Accepted: April 28, 2021; Published: May 15, 2021

Citation: Fanton L, Nahmani I, Epain M, et al. Forensic Autopsy-Confirmed COVID-19-Induced Out-of-Hospital Cardiac Arrest: Case Report. Clin Image Case Rep J. 2021; 3(4): 159.

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Abstract

Background: In the setting of severe acute respiratory syndrome coronavirus 2 (SARSCoV?2) infection, data from autopsy in subjects who died at home during lockdown are scarce. We here report a forensic autopsy series of coronavirus disease 2019 (COVID-19)-related out-of-hospital cardiac arrest (OHCA).

Methods and Results: Between March and April 2020, four COVID-19-related OHCA were autopsied at the Institute of Legal Medicine of the metropolitan area of Lyon (France). Autopsies of 3 individuals reported natural death by acute respiratory failure implicating SARS-CoV-2 with typical COVID-19 pulmonary aspect of gross findings and pulmonary microscopy findings, i.e. diffusely congestive edematous lungs with peripheral thrombi and diffuse alveolar damage (DAD) at different stages of inflammatory reaction. For one individual, autopsy concluded of violent death due to suicidal acute alcohol intoxication in a patient that could no longer endure COVID-19 lockdown. No significant lesions were found in the heart.

Conclusions: We report here OHCAs of non-cardiac cause directly implicating COVID?19 at various stages of SARS-CoV-2-related DAD. This autopsy remains of interest during this epidemic, both legally and medically to better understand the pathogenic processes of this infectious disease.

Keywords: Autopsy; COVID-19; SARS-CoV-2 infection; Cardiac arrest