Written by Christina Crowe
A multi-institutional paper on COVID autopsies published in Archives of Pathology and Laboratory Medicine was awarded the United States and Canadian Academy of Pathologists' L.Clark Jr. and Elaine F. Stout Award for best Anatomic Pathology paper in 2022.
UAB Pathology faculty authors include Paul Benson, M.D., Associate Professor; Stephanie Reilly, M.D., Associate Professor (retired), and Silvio Litovsky, M.D., Professor. Benson is director of the Autopsy Section, taking over for Litovsky in the role in 2020.
The paper, titled, "A Postmortem Portrait of the Coronavirus Disease 2019 (COVID-19) Pandemic: A Large Multi-institutional Autopsy Survey Study," was published in the May 2021 issue of Archives.
“I am very proud of the UAB autopsy faculty for participating in this important multi-institutional study," Benson says. "The entire autopsy faculty and staff worked tirelessly during the pandemic and this publication is a direct result of that work. The honor of the USCAP Stout Award for best paper in AP shows how important all of the COVID-19 autopsies were in contributing to medical knowledge of an emerging infectious disease. We look forward to more collaborations and appreciate the departmental support during the pandemic.”
Dr. Jody Hooper, first author, accepted the award on behalf of the authors. Hooper is autopsy director at Stanford University.
The study represents the largest compilation to date of clinical and postmortem data from decedents with coronavirus disease 2019 (COVID-19). It aims to augment previously published small series of autopsy case reports, refine clinicopathologic considerations, and improve the accuracy of future vital statistical reporting. The objective, to accurately reflect the preexisting diseases and pathologic conditions of decedents with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection through autopsy, was achieved by gathering comprehensive data from 135 autopsy evaluations of COVID-19 positive decedents. Postmortem examinations were performed by 36 pathologists at 19 medical centers or forensic institutions in the United States and Brazil. Data from each autopsy were collected through the online submission of multiple-choice and open-ended survey responses.
The authors found that, "patients dying of or with COVID-19 had an average of 8.89 pathologic conditions documented at autopsy, spanning a combination of prior chronic disease and acute conditions acquired during hospitalization. Virtually all decedents were cited as having more than 1 preexisting condition, encompassing an average of 2.88 such diseases each. Clinical conditions during terminal hospitalization were cited 395 times for the 135 autopsied decedents and predominantly encompassed acute failure of multiple organ systems and/or impaired coagulation. Myocarditis was rarely cited."
They concluded, "Cause-of-death statements in both autopsy reports and death certificates may not encompass the severity or spectrum of comorbid conditions in those dying of or with COVID-19."
The Dr. L. Clarke, Jr. and Elaine F. Stout Award was established in 2015 by the generous support of Dr. L. Clarke, Jr. and Elaine F. Stout. This award will ensure that pathologists endeavoring to resolve scientific medical problems by studying their anatomic features are supported and appreciated in perpetuity. The Stout Award will provide recognition and an award of $3,000 to an individual for the best English language peer-reviewed paper published during the twelve months preceding the application deadline, which resolved scientific medical problems by studying their anatomic features. The award selection is made by the Stout Award Committee.