Original Research

Causes of death and post-mortem testing for SARS-CoV-2 in a tertiary hospital during the COVID-19 pandemic in Ghana

Edward Asumanu, Seth Attoh, Raymond X. Servor, Clement Laryea, Mary McAddy, Fred Hobenu, Raymond Factchu, Kwesi Agyemang-Bediako, Edward O. Nyarko, Godwin K. Nyarko, Marcus K. Moroti, Lawrence Edusei
African Journal of Laboratory Medicine | Vol 11, No 1 | a1766 | DOI: https://doi.org/10.4102/ajlm.v11i1.1766 | © 2022 Edward Asumanu, Seth Attoh, Raymond X. Servor, Clement Laryea, Mary McAddy, Fred Hobenu, Raymond Factchu, Kwesi Agyemang-Bediako, Edward O. Nyarko, Godwin K. Nyarko, Marcus K. Moroti, Lawrence Edusei | This work is licensed under CC Attribution 4.0
Submitted: 19 October 2021 | Published: 23 November 2022

About the author(s)

Edward Asumanu, Postgraduate College, 37 Military Hospital, Accra, Ghana
Seth Attoh, Department of Anatomical Pathology, 37 Military Hospital, Accra, Ghana
Raymond X. Servor, Department of Anatomical Pathology, 37 Military Hospital, Accra, Ghana
Clement Laryea, Department of Medicine, 37 Military Hospital, Accra, Ghana
Mary McAddy, Department of Anatomical Pathology, 37 Military Hospital, Accra, Ghana
Fred Hobenu, Department of Anatomical Pathology, 37 Military Hospital, Accra, Ghana
Raymond Factchu, Department of Anatomical Pathology, 37 Military Hospital, Accra, Ghana
Kwesi Agyemang-Bediako, Department of Anatomical Pathology, 37 Military Hospital, Accra, Ghana
Edward O. Nyarko, Public Health Division, 37 Military Hospital, Accra, Ghana
Godwin K. Nyarko, Department of Anatomical Pathology, 37 Military Hospital, Accra, Ghana
Marcus K. Moroti, Department of Anatomical Pathology, 37 Military Hospital, Accra, Ghana
Lawrence Edusei, Department of Anatomical Pathology, 37 Military Hospital, Accra, Ghana


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Abstract

Background: Causes of death during the coronavirus disease 2019 (COVID-19) pandemic ranhttp://crossmark.crossref.org/dialog/?doi=10.4102/ajlm.v11i1.1766=pdf&date_stamp=2022-11-23ge from direct consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to deaths unrelated to SARS-CoV-2. Another feature of the pandemic is the post-mortem testing for SARS-CoV-2. Understanding these aspects of COVID-19 are essential in planning and limiting the impact of SARS-CoV-2 virus on healthcare systems.

Objective: This study investigated the underlying causes of death and the presence of SARS-CoV-2 in bodies received at the 37 Military Hospital, Accra, Ghana, during the COVID-19 pandemic.

Methods: The study was conducted from 4–27 May 2020. Deceased patients that met the inclusion criteria were prospectively selected during the expanded surveillance period for SARS-CoV-2 testing, autopsy and determination of underlying and immediate cause of death.

Results: A total of 161 deceased patients were analysed with 53 autopsies. The overall positive test rate for SARS-CoV-2 was 14.9% (24/161 patients), with a positive rate of 5.0% (8/161 patients) for nasopharyngeal samples and 30.2% (16/161 patients) for bronchopulmonary samples. The underlying causes of death were not related to SARS-CoV-2 infection in 85.1% (137/161) of patients, SARS-CoV-2-associated 12.4% (20/161) and SARS-CoV-2-induced in 2.5% (4/161). Cardiovascular complications formed the most common cause of death in patients with or without SARS-CoV-2.

Conclusion: There was a high positive rate of SARS-CoV-2 in post-mortem cases. However, most deaths were not caused by SARS-CoV-2 but by cardiovascular complications. The high rate of bronchopulmonary positive results for SARS-CoV-2 requires that autopsies be done in suspicious cases with negative nasopharyngeal sampling.

 


Keywords

post-mortem; severe acute respiratory syndrome coronavirus 2; coronavirus disease 2019; surveillance; pathology

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