Postmortem CT lung findings in decedents with Covid-19: A review of 14 decedents and potential triage implications

Objective: Computed tomography has significant utility as a diagnostic tool for coronavirus disease 2019 (COVID19) in the clinical setting. COVID-19 deaths are sometimes examined by forensic pathologists, often in the setting of an unknown diagnosis. We assessed the utility of postmortem computed tomography (PMCT) for use as a triage tool for these autopsy examinations. Materials and methods: We reviewed PMCT findings in 14 and histopathology in 11 decedents who were positive for COVID-19. Results: The predominant imaging findings were bilateral mixed densities, in either a diffuse or peripheral distribution, with traction bronchiectasis, and/or crazy paving. In particular, traction bronchiectasis, ill-defined rounded consolidations, and reverse halo sign are useful when distinguishing from other postmortem changes. Conclusion: We conclude that triage with a PMCT may aid the forensic pathologist in diagnosing possible COVID19 infection prior to autopsy examination.