Post-mortem diagnosis of COVID-19

We would like to share our impression on the report ‘Postmortem diagnosis of COVID-19: Antemortem challenges of three cases at the 37 Military Hospital, Accra, Ghana’.1 Attoh et al. concluded that ‘The outcome of COVID-19 testing is dependent on the sample type and accuracy of sampling amongst other factors’1 and suggested that ‘more autopsies are required to fully understand the pathogenesis of this disease in Ghanaians’.1 Indeed, post-mortem diagnosis of coronavirus disease 2019 (COVID-19) is possible and there are many reports of the existence of pathogenic viruses in autopsy specimens.2,3 Autopsy is also very useful for understanding the pathogenesis of this new disease. However, it must be performed with high caution. While there are no confirmed cases of the pathogen being spread from deceased patients, infection of forensic pathology workers has been reported.4 More autopsies might be recommended, but adequate biosafety and biosecurity, and other infection control precautions must be in place for these to occur.