COVID-19 autopsy reports from the Ga-East Municipal and the 37 Military Hospitals in Accra, Ghana

Ghana Med J. 2020 Dec;54(4 Suppl):52-61. doi: 10.4314/gmj.v54i4s.9.

Abstract

Introduction: Since the declaration of COVID-19 by the World Health Organisation (WHO) as a global pandemic on 11th March 2020, the number of deaths continue to increase worldwide. Reports on its pathologic manifestations have been published with very few from the Sub-Saharan African region. This article reports autopsies on COVID-19 patients from the Ga-East and the 37 Military Hospitals to provide pathological evidence for better understanding of COVID-19 in Ghana.

Methods: Under conditions required for carrying out autopsies on bodies infected with category three infectious agents, with few modifications, complete autopsies were performed on twenty patients with ante-mortem and/or postmortem RT -PCR confirmed positive COVID-19 results, between April and June, 2020.

Results: There were equal proportion of males and females. Thirteen (65%) of the patients were 55years or older with the same percentage (65%) having Type II diabetes and/or hypertension. The most significant pathological feature found at autopsy was diffuse alveolar damage. Seventy per cent (14/20) had associated thromboemboli in the lungs, kidneys and the heart. Forty per cent (6/15) of the patients that had negative results for COVID-19 by the nasopharyngeal swab test before death had positive results during postmortem using bronchopulmonary specimen. At autopsy all patients were identified to have pre-existing medical conditions.

Conclusion: Diffuse alveolar damage was a key pathological feature of deaths caused by COVID-19 in all cases studied with hypertension and diabetes mellitus being major risk factors. Individuals without co-morbidities were less likely to die or suffer severe disease from SARS-CoV-2.

Funding: None declared.

Keywords: COVID-19; Diffuse Alveolar Damage; Ghana; autopsy; thromboemboli.

MeSH terms

  • Autopsy / statistics & numerical data*
  • COVID-19 / mortality
  • COVID-19 / pathology*
  • COVID-19 Testing / methods
  • COVID-19 Testing / statistics & numerical data
  • Comorbidity
  • Diabetes Mellitus, Type 2 / mortality
  • Diabetes Mellitus, Type 2 / virology
  • Female
  • Ghana / epidemiology
  • Hospitals, Military / statistics & numerical data*
  • Hospitals, Municipal / statistics & numerical data*
  • Humans
  • Hypertension / mortality
  • Hypertension / virology
  • Lung / pathology
  • Lung / virology
  • Male
  • Middle Aged
  • Pulmonary Alveoli / pathology
  • Pulmonary Alveoli / virology
  • Risk Factors
  • SARS-CoV-2*