For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
12
views
16
references
 Top references
cited by
2
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
1 collections
    0
    shares
      252
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: not found

      Coronial postmortem reports and indirect COVID-19 pandemic-related mortality

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Aims

          Widespread disruption of healthcare services and excess mortality not directly attributed to COVID-19 occurred between March and May 2020. We undertook the first UK multicentre study of coroners’ autopsies before and during this period using postmortem reports.

          Methods

          We reviewed reports of non-forensic coroners’ autopsies performed during the first COVID-19 lockdown (23 March to 8 May 2020), and the same period in 2018. Deaths were categorised as natural non-COVID-19, COVID-19-related, non-natural (suicide, drug and alcohol-related, traumatic, other). We provided opinion regarding whether delayed access to medical care or changes in behaviour due to lockdown were a potential factor in deaths.

          Results

          Seven centres covering nine coronial jurisdictions submitted a total of 1100 coroners’ autopsies (498 in 2018, 602 in 2020). In only 54 autopsies was death attributed to COVID-19 (9%). We identified a significant increase in cases where delays in accessing medical care potentially contributed to death (10 in 2018, 44 in 2020). Lockdown was a contributing factor in a proportion of suicides (24%) and drug and alcohol-related deaths (12%).

          Conclusions

          Postmortem reports have considerable utility in evaluating excess mortality due to healthcare and wider societal disruption during a pandemic. They provide information at an individual case level that is not available from assessment of death certification data. Detailed evaluation of coroners’ autopsy reports, supported by appropriate regulatory oversight, is recommended to mitigate disruption and indirect causes of mortality in future pandemics. Maintaining access to healthcare, including substance misuse and mental health services, is an important consideration.

          Related collections

          Most cited references16

          • Record: found
          • Abstract: found
          • Article: found

          Estimating excess 1-year mortality associated with the COVID-19 pandemic according to underlying conditions and age: a population-based cohort study

          Amitava Banerjee, Laura Pasea, Steve Harris … (2020)
          Summary Background The medical, societal, and economic impact of the coronavirus disease 2019 (COVID-19) pandemic has unknown effects on overall population mortality. Previous models of population mortality are based on death over days among infected people, nearly all of whom thus far have underlying conditions. Models have not incorporated information on high-risk conditions or their longer-term baseline (pre-COVID-19) mortality. We estimated the excess number of deaths over 1 year under different COVID-19 incidence scenarios based on varying levels of transmission suppression and differing mortality impacts based on different relative risks for the disease. Methods In this population-based cohort study, we used linked primary and secondary care electronic health records from England (Health Data Research UK–CALIBER). We report prevalence of underlying conditions defined by Public Health England guidelines (from March 16, 2020) in individuals aged 30 years or older registered with a practice between 1997 and 2017, using validated, openly available phenotypes for each condition. We estimated 1-year mortality in each condition, developing simple models (and a tool for calculation) of excess COVID-19-related deaths, assuming relative impact (as relative risks [RRs]) of the COVID-19 pandemic (compared with background mortality) of 1·5, 2·0, and 3·0 at differing infection rate scenarios, including full suppression (0·001%), partial suppression (1%), mitigation (10%), and do nothing (80%). We also developed an online, public, prototype risk calculator for excess death estimation. Findings We included 3 862 012 individuals (1 957 935 [50·7%] women and 1 904 077 [49·3%] men). We estimated that more than 20% of the study population are in the high-risk category, of whom 13·7% were older than 70 years and 6·3% were aged 70 years or younger with at least one underlying condition. 1-year mortality in the high-risk population was estimated to be 4·46% (95% CI 4·41–4·51). Age and underlying conditions combined to influence background risk, varying markedly across conditions. In a full suppression scenario in the UK population, we estimated that there would be two excess deaths (vs baseline deaths) with an RR of 1·5, four with an RR of 2·0, and seven with an RR of 3·0. In a mitigation scenario, we estimated 18 374 excess deaths with an RR of 1·5, 36 749 with an RR of 2·0, and 73 498 with an RR of 3·0. In a do nothing scenario, we estimated 146 996 excess deaths with an RR of 1·5, 293 991 with an RR of 2·0, and 587 982 with an RR of 3·0. Interpretation We provide policy makers, researchers, and the public a simple model and an online tool for understanding excess mortality over 1 year from the COVID-19 pandemic, based on age, sex, and underlying condition-specific estimates. These results signal the need for sustained stringent suppression measures as well as sustained efforts to target those at highest risk because of underlying conditions with a range of preventive interventions. Countries should assess the overall (direct and indirect) effects of the pandemic on excess mortality. Funding National Institute for Health Research University College London Hospitals Biomedical Research Centre, Health Data Research UK.
          Article 0 comments Cited 269 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Autopsy in suspected COVID-19 cases

            Brian Hanley, Sebastian B Lucas, Esther Youd … (2020)
            The severe acute respiratory syndrome (SARS)-coronavirus-2 (CoV-2) outbreak in Wuhan, China, has now spread to many countries across the world including the UK with over 3000 deaths as of early March 2020. This will inevitably lead to an increase in the number of suspected coronavirus disease 2019 (COVID-19)-related deaths at autopsy. The Royal College of Pathologists has responded to this concern with the release of guidelines on autopsy practice relating to COVID-19. The following article is a summary and interpretation of these guidelines. It includes a description of hazard group 3 organisms to which SARS-CoV-2 has been assigned, a brief description of what is currently known about the pathological and autopsy findings in COVID-19, a summary of the recommendations for conducting autopsies in suspected COVID-19 cases and the techniques for making the diagnosis at autopsy. It concludes by considering the clinicopathological correlation and notification of such cases.
            Article 0 comments Cited 235 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found

              Excess Deaths From COVID-19 and Other Causes, March-April 2020

              Steven H Woolf, Derek Chapman, Roy T Sabo … (2020)
              This study uses data from the National Center for Health Statistics to estimate excess deaths (ie, the difference between observed and expected deaths) in the US and the District of Columbia in the early weeks of the COVID-19 pandemic.
              Article 0 comments Cited 201 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): J Clin Pathol
                Journal ID (iso-abbrev): J Clin Pathol
                Journal ID (hwp): jclinpath
                Journal ID (publisher-id): jcp
                Title: Journal of Clinical Pathology
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Print): 0021-9746
                ISSN (Electronic): 1472-4146
                Publication date (Print): January 2022
                Publication date (Electronic): 15 January 2022
                Publication date PMC-release: 15 January 2022
                Electronic Location Identifier: jclinpath-2021-208003
                Affiliations
                [1 ]departmentDepartment of Cellular Pathology , Oxford University Hospitals NHS Foundation Trust , Oxford, UK
                [2 ]departmentDepartment of Histopathology, Northern General Hospital , The University of Sheffield , Sheffield, UK
                [3 ]departmentSchool of Medical Education , Newcastle University School of Clinical Medical Sciences , Newcastle upon Tyne, UK
                [4 ]departmentEast Midlands Forensic Pathology Unit , University of Leicester , Leicester, UK
                [5 ]departmentDepartment of Cellular Pathology , Guy’s and St Thomas’ NHS Foundation Trust , London, UK
                [6 ]departmentDepartment of Cellular Pathology , Imperial College Healthcare NHS Foundation Trust , London, UK
                [7 ]departmentDepartment of Cellular Pathology , Buckinghamshire Healthcare NHS Trust , High Wycombe, UK
                [8 ]departmentDepartment of Cellular Pathology , Milton Keynes University Hospital NHS Foundation Trust , Milton Keynes, UK
                [9 ]departmentDepartment of Cellular Pathology , West Hertfordshire Hospitals NHS Trust , Watford, UK
                [10 ]departmentNuffield Department of Population Health , University of Oxford , Oxford, UK
                Author notes
                [Correspondence to ] Professor Ian S D Roberts, Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK; Ian.Roberts@ 123456OUH.nhs.uk
                Author information
                http://orcid.org/0000-0003-2371-0403
                Article
                Publisher ID: jclinpath-2021-208003
                DOI: 10.1136/jclinpath-2021-208003
                PMC ID: 8783968
                PubMed ID: 35039447
                SO-VID: 8194947a-509a-403f-8dc9-22d8e2e5844e
                Copyright © © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
                License:

                This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

                History
                Date received : 11 November 2021
                Date accepted : 23 December 2021
                Categories
                Subject: Original Research
                Custom metadata
                access-type free

                ScienceOpen disciplines: Pathology
                Keywords: reports,autopsy,covid-19,death,epidemiology
                Data availability:
                ScienceOpen disciplines: Pathology
                Keywords: reports, autopsy, covid-19, death, epidemiology

                Comments

                Comment on this article