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Pathologists call for more autopsies to understand coronavirus

Failing to perform autopsies on deceased Covid patients in Finland is a lost opportunity for science, experts say.

Patologi Jonas Kantonen obduktiosalissa
Helsinki University Hospital pathologist Jonas Kantola says Finland's autopsy system is too slow for modern medicine, particularly during an epidemic. Image: Pekka Tynell / Yle

Pathologists in Finland say performing more autopsies sooner would benefit scientific research.

Jonas Kantonen, a pathologist at Helsinki University Hospital, criticised current autopsy practices, dating back to the 1970s, as outdated.

"Many of the molecules we could study disintegrate very quickly after death...this means we lose a lot of information," he explained.

Kantonen would ideally like to see postmortems performed less than 12 hours after death. Slowing the process down in Finland is the fact that the deceased’s family must give permission for an autopsy.

"From a virus mechanism standpoint, it’s a real shame to lose this window," said Mikko Mäyränpää, chairman of the Finnish pathologists association.

Kantonen told Yle that postmortem information this spring helped guide Covid treatment strategies.

"Our first coronavirus autopsy showed pulmonary embolism, or blood clots in the lungs," Kantonen explained, adding that this discovery underscored the importance of blood thinners--even after patients are discharged from hospital.

Coronavirus autopsies in Finland have detected the virus in the body 23 days after death.

Autopsies are generally rare in Finland. In the 1970s, they were performed in nearly one in five cases. Today that figure is around four percent as patients' diagnoses have become more accurate.

For the greater good

In Finland it’s not possible for a person to request an autopsy for when they die. Money is also an issue when it comes to performing more post-death examinations. The state pays for forensic autopsies, whereas municipalities foot the bill for medical ones.

Kantonen suggested universities could step in to cover the costs of autopsies performed for scientific research.

"It’s a strange system. The thinking seems to be to bury the dead as quickly as possible and better yet cremate them to keep the virus from spreading--it’s not that contagious," Mäyränpää said.

Kantonen and Mäyränpää pointed to Germany, where authorities can order an autopsy if the information potentially gleaned could benefit society.

This year the capital region has seen a rise in autopsies. Helsinki and Uusimaa hospital district (HUS) had performed 600 postmortem exams by October--as many as during all of last year.

Tampere and Oulu have meanwhile recorded fewer autopsies than usual.

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