Autopsies Give Insights Into COVID-19 Virus

A series of autopsies conducted on deceased COVID-19 patients have revealed some important insights which must be considered in the clinical treatment of the disease, according to the forensic doctor responsible for the autopsies.

Liu Liang, a professor of legal medicine at the Tongji Medical College in Wuhan, the epicenter of the outbreak since mid-December, revealed some of the findings during a recent interview with China Central Television (CCTV).

On Feb. 16, Liu's team performed the first autopsy surgery on a deceased patient who succumbed to lung disease brought on by the viral pneumonia. The team published the first autopsy report of its kind by releasing a preview version on Friday. So far, Chinese scientists have dissected 12 bodies, nine of which were conducted by Liu's team.

The pathological findings show COVID-19 has similarities to the severe acute respiratory syndrome (SARS) which originated in 2002-3, but the disease also has its own characteristics, said Liu. According to the autopsy report, the disease mainly causes distal alveolar damages, and a large amount of sticky mucus secretion was found in the deceased patients' airways and in the lungs, an issue which should be addressed during treatment.

"[The secretion] is very sticky. It attaches to [the lung] like paste. This may reflect that the patient had mucus secretion in the early state, which is different from what we called 'catarrh'--the symptom like thin clear snivel from an ordinary cold or virus infection. So what does it reflect? The mucus was in the deep-seated airway. If we don't give targeted treatment, it may be counter-productive," said Liu.

Liu stressed that the information gained from the autopsy will prove very important in helping researchers and doctors improve medical treatment plans for patients.

"For example, a normal lung touches like a sponge because it contains air. But a lung [infected by novel coronavirus] doesn't touch like this. It's no longer a lung - it's a consolidation. Something else refilled in the lung. So you must know what the pathological change is and give targeted treatment. Otherwise it will be useless, like delivering oxygen through a blocked path. You must unblock the road before sending a vehicle," said Liu.

Due to a lack of comprehensive pathological information, researchers have been unable to make exact judgement on the pathogenesis of COVID-19 as well as the damages it causes to organs. Though Liu had been calling for conducting autopsies to deceased patients, it remains a very dangerous procedure which could expose the virus.

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