Covid 19 sufferers pose a health risk not only to doctors and nurses. They also pose a risk after death.
For the protective alignment, this means: “With the FFP3 mask, safety glasses or protective mask, suit and gloves, it corresponds exactly to that of doctors and nurses during the smear in suspected corona cases or in the care of hospitalized Covid-19 sufferers, “said the expert.
Fear of infection through the air
The pathologists also exercise particular caution when performing the autopsy itself: it is carried out in special rooms of biosafety level 2 (BSL 2), which are separated from the outside world by, for example, locks. Usually these are used for the sectioning of corpses with hepatitis C or HIV, which are also contagious after death. The material used is specially disposed of in biohazard bags.
Unlike normal autopsy of corona dead people, water must not run, explains Perren. This is to prevent that when the body is cut open, infectious virus particles are released, which can dock onto the aerosols generated by the water jet – tiny droplets that float through the room – and spread through the air. There are indications that this is possible. Researchers at the Institute for Environmental Medicine (IEM) at the Helmholtz Center in Munich are currently investigating whether and to what extent Spiegel.de writes.
No removal of organ packages
Also in the pathology of the University Hospital Basel (USB), where most of the Covid 19 victims in Switzerland have been autopsied with twelve autopsies so far, special safety precautions apply: “Instead of taking whole organ packages out of the corpses and then examining them, autopsying them the organs now except the lungs in the body, “explains Alexandar Tzankov, Head of Histopathology and Autopsy at the USB.
This autopsy in corpore method is intended to prevent pathologists from coming into contact with more blood and body fluids than is absolutely necessary. “After the last breath, these secretions, which can drip and splash, pose the greatest risk of infection,” says Tzankov. He cannot say how long this lasts for Sars-CoV-2, “for that you would first have to at least specifically infect animals, which will not happen”. But hepatitis C, for example, knows “that the infectivity decreases drastically three hours after death and tends to zero 24 hours afterwards.”
Previous illnesses and causes of death
The effort of the pathologists pays off: The experts were able to gain knowledge that could be important for science in the fight against the coronavirus. Tzankov’s team was able to show that the twelve autopsied Covid-19 deceased (2 women and 10 men between 56 and 96 years) all suffered from arterial hypertension; In contrast, 82 percent had taken antihypertensives from the group of sartans or ACE inhibitors. 82 percent were very overweight. 40 percent of the deceased had smoked. 35 percent had diabetes and 15 percent had cancer. Also was blood group A significantly over-represented. A lot fits the findings of epidemiological studies.
“With one exception, all of the deceased were full of viruses,” said the pathologist. Only one woman had been completely eliminated when she died. “This shows that Sars-CoV-2 triggers a cascade of body responses that ultimately lead to death rather than direct viral damage to the lung cells.”
Another finding: “Surprisingly, the deceased showed signs of pneumonia,” reports Tzankov. Rather, the histological examinations indicated that “the blood flow to the lungs – the so-called microcirculation – and the gas exchange membranes are clearly disturbed.” The pathologist suspects that this could explain why Covid 19 patients who are seriously ill despite ventilation are so difficult to rescue.