Coronavirus Pesaro, in the autopsies the key to the mystery – Chronicle


Pesaro, 5 June 2020 – Covid19 is the autopsy knot. That are not done. And those made can be counted on the fingers. Yet it is the only means that allows you to photograph what happened inside the body, if it was the virus that killed and how, and once this has been clarified, what therapies to use to defeat it. But also, not least, what mistakes not to repeat. Mistakes that, in some cases, may have cost some life. To untie the knot is Professor Adriano Tagliabracci, director of the biomedical sciences and public health department.

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Professor Tagliabracci, how many autopsies were made in the Marche region compared to the nearly 1000 deaths from Covid?

«From April 10th we will have done at most 5 or 6».

Why from April 10, one month after the peak of March deaths?

“Because on 1 and 8 April, as well as at the end of May, circulars came out saying that autopsies for judicial or clinical purposes could only be done if the sector rooms respected certain anti-infection safety parameters. It therefore rises to negative pressure, with filters to expel the air outside, in short, a whole series of precautions to prevent operators from falling ill with Covid. On April 10, I asked the management of the assembled hospitals of Ancona to equip the room according to the canons of the circular and I obtained it. It cost 8 thousand euros. We started with the autopsies. The indication is that there should be a standard room in each province. But for now we only have it here in Ancona “.

Why so few post mortem investigations?

“I don’t decide if and when to perform autopsies.”

And who decides whether to do them or not?

“The attending physician decides whether the deaths occurred in the hospital or the general practitioner if they died at home. Or the prosecutors of the Republic if there is a hypothesis of crime. And so far there are very few autopsies that have instructed us to perform. I wish I could do more. It is very important. The resuscitators themselves asked us to. ”

What have you understood about the virus from the tests carried out so far?

“They all died for Covid. We studied the pathogenesis, or the path that the virus made in the body. We have seen that the attachment points are the lungs but also the cardiovascular system. The receptors for the virus are in the lungs, intestines, cardiovascular system, prostate. The latter figure explains why more men than women died. Understanding how it attacks the disease allows to implement ad hoc therapies. Those used at the beginning, such as hydroxychloroquine, were emergency therapies that did damage. ”

But if we had left earlier with the autopsies, would errors and perhaps even death be avoided?

“Maybe yes. Another mistake was the lack of an effective prevention plan to contain the infection. People had to be treated at home, they were not to be sent to the hospital where many died. Ventilation had to be reserved only for some cases and not for all ».

Is that many GPs didn’t go home …

«Many doctors went and several fell ill and died. But I know of others who have refused to visit patients at home. And this is a deontological violation as well as the Hippocratic oath ».

And if a new wave comes, how do we face it?

«With a new lockdown. The most effective measure is distancing. For infectious diseases, the system is old: isolation of the contagious. Looking forward to finding a vaccine. But then again, they have to make us do multiple autopsies. The morgue is the place where death helps people live. ”

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