This post was reviewed by Dr. Jasmin Chahal, one of our subject matter experts.
The paper we’ll be demystifying can be found here, if you’d like to follow along!
Autopsy reports reveal that a man had fallen from a height of 3 metres because he had passed away from COVID-19.
Currently, there are many conspiracy theories prevalent on social media surrounding deaths that may be wrongly reported as COVID-19. Among these conspiracy theories is the one related to the present case study. Many people believe that the cause of death of the man in the present study was wrongly reported as COVID-19. Specifically, these conspiracy theorists believe that health officials reported his death as COVID-19 to increase the number of COVID-19 cases.
Emergency operators were called as construction workers reported that a 51-year-old Caucasian male was found near a scaffolding that was installed approximately 3m above the yard of a house. When the emergency medical service (EMS) team arrived, the construction workers reported that the male was a construction worker who likely fell from the scaffolding. The EMS team could not detect any vital signs. Therefore, resuscitation was immediately performed. Resuscitation failed and the male was pronounced as dead.
Due to the insufficient information available on events that may have caused the death, police and a coroner were informed and arrived at the scene, shortly afterwards. The coroner performed an external examination on the body and found wounds on the forehead, minor scrapes on the elbow and face, as well as a bruise on the left hand. Traces of blood were also found near the head. As the death was caused by unknown circumstances, a forensic autopsy was ordered.
The construction workers at the scene were colleagues of the 51-year-old male. They reported to the police that none of them witnessed the male falling. As there were no medical records present at the scene, the police gathered health information from the colleagues who had been living with him for the past 10 days. The police found that the 51-year-old was a long-time smoker and suffered from type-2 diabetes. The colleagues also revealed that a week prior to his death, the 51-year-old had been complaining of shortness of breath, fatigue, headache, chest discomfort, cough and fever and refused to see a doctor, prior to his death for these conditions.
Why Was a Covid-19 Test Performed?
After resuscitation was performed, a nasal swab was taken from the deceased male for a SARS-CoV-2 analysis. This was to ensure the safety of the EMS members who performed the resuscitation, as well as the other members of the EMS team, the police officers and the coroner, who were all in contact with one another, as well as the deceased male. Test results from the RT-PCR analysis confirmed the presence of SARS-CoV-2. Thus, it was concluded that the deceased male tested positive for COVID-19.
As the 51-year-old tested positive for COVID-19, the autopsy staff used personal protective equipment, such as medical gowns, eye protection and face masks, during the autopsy. This was to ensure the safety of the autopsy staff.
The EMS members who performed the resuscitation were immediately tested for COVID-19 and their test results were negative. It was concluded that the transmission of COVID-19 from the 51-year-old deceased male to the EMS members did not occur.
Discussion: Cause of Death
The autopsy revealed that the cause of death was COVID-19, and the manner of death was natural. Smoking, type-2 diabetes, fibrosis, atherosclerosis and myocardial hypertrophy were also listed as contributing factors of death.
The autopsy further revealed that symptoms in the body were consistent with SARS-CoV-2. For example, acute respiratory distress syndrome is commonly found in COVID-19 patients. The deceased had diffused alveolar damage in the lungs, which is a common symptom of acute respiratory distress syndrome.
The 51-year-old also displayed signs of liver damage. Specifically, microabscesses, severe cyanosis and focal necrosis were all present in the liver. This may be due to direct viral attack as liver damage has been previously reported in other COVID-19 patients. Neutrophils were also found in the blood vessels of the lungs and heart, as well as the liver. There have been other studies that report neutrophils as potentially being related to SARS-CoV-2 infection damage. Some researchers believe that the presence of neutrophils may be another indication of COVID-19. Further research on the relationship between neutrophils and SARS-CoV-2 must be conducted to confirm this relationship. This would be beneficial for future autopsies.
Overall, majority of symptoms found in the autopsy were consistent with SARS-CoV-2. Therefore, the cause of death was reported to be COVID-19. The 51-year-old deceased also had evidence of other medical conditions, such as myocardial hypertrophy, fibrosis, atherosclerosis, type-2 diabetes and was a known smoker. There is actually research that shows that people with chronic diseases may be more prone to severe forms of COVID-19. Studies have shown that diabetes ranks high as a co-morbidity in COVID-infected patients and COVID-19 infection may be more severe in smokers.
Conclusion and Implications
The present study considerably contributed to the limited research on COVID-19 pathological findings. Accordingly, the researchers analyzed the autopsy of the COVID-19 victim and in doing so, informed the reader about the implications of SARS-CoV-2 among smoker and diabetic individuals. However, further research must be conducted to provide more research and data.
Based on this case, the authors of this article stress that healthcare and autopsy professionals must stay vigilant for COVID-19 with the on-going pandemic. Violent deaths (such as a violent fall) can hide SARS-CoV-2 as the true cause of death. Towards this, we as the general population must also be aware that conspiracy theories surrounding coroners falsely reporting deaths as COVID-19 to “increase the number of COVID-19 cases” may actually be untrue.