Yıl: 2020 Cilt: 17 Sayı: 3 Sayfa Aralığı: 282 - 291 Metin Dili: Türkçe DOI: 10.5336/forensic.2020-77074 İndeks Tarihi: 21-06-2021

COVID-19 Enfeksiyonu ve Adli Tıp

Öz:
Koronavirüs hastalığı-2019 [coronavirus disease-2019(COVID-19)] enfeksiyonu; 2019 yılı Aralık ayında, Çin’in Hubei eyaletinin Wuhan şehrinde ilk kez tanımlanmıştır. Etken virüs, 2002 yılında tanımlanan şiddetli akut solunum sendromu [severe acuterespiratory syndrome (SARS)] virüsü ile benzerliği sebebiyle SARSCoV-2 olarak isimlendirilmiştir. Hızla yayılan enfeksiyon, 11 Mart2020 tarihinde Dünya Sağlık Örgütü tarafından pandemi olarak duyurulmuştur. Hastalığın klinik belirtileri, oldukça geniş bir yelpazede seyretmektedir. En sık görülen semptomlar ateş, kuru öksürük, miyalji veyayorgunluk ile nefes darlığıdır. Virüsün bulaşıcılığı, önceki yıllarda tanımlanan CoV’lere oranla çok daha yüksektir. Asemptomatik kişilerin,bulaştırıcı olabileceği de bildirilmiştir. Hastalık tanısı, genellikle nazofarengeal sürüntü örneklerine revers transkripsiyon-polimeraz zincirreaksiyonu testi yapılarak konulmaktadır. Direkt grafi ve bilgisayarlıtomografi, tanıda destekleyicidir. Hastalığın prognozunda, immün sistem fonksiyonları önemli rol oynamaktadır. Ölümle sonuçlanan olgularda, genellikle kronik ek hastalıklar mevcuttur. COVID-19enfeksiyonunda, adli tıp polikliniklerinde acil olmayan muayeneler ertelenmiştir. Kliniklerde çalışan adli tıp uzmanı ve yardımcı personel,standart kişisel koruyucu ekipman önlemlerine uygun giyinmelidir.Postmortem işlemler sırasında morg çalışanları, çok yüksek riskli sınıfta kabul edildiğinden standart önlemlere ek olarak en az FFP2 ya daN95 maske, yüz koruyucu siperlik, plastik dezenfekte edilebilir çizmeve su geçirmez önlük kullanmalıdır. Postmortem incelemeler sırasındaotopsi kararı verilirken, adli tıp kurumunun yayımladığı algoritmalarauygun olarak öncelikle nazofarengeal örnek alınarak sonucu beklenmelidir. Pozitif olgularda, mümkünse ölü muayenesi ile defin ruhsatıverilmelidir. Adli olgulara otopsi, mümkünse negatif basınçlı salonlardayapılmalıdır. COVID-19 enfeksiyonunda yapılan sınırlı sayıdaki otopsiçalışmalarında; yaygın alveoler hasar, havayolu inflamasyonu, plörezi,perikardit, akciğer konsolidasyonu ve pulmoner ödem gibi ağırlıklı olarak solunum sistemi patolojileri saptanmıştır.
Anahtar Kelime:

COVID-19 Infection and Forensic Medicine

Öz:
Coronavirus disease-2019 (COVID-19) infection was first described in the city of Wuhan in the Hubei province of China in December 2019. The causative virus was named SARS-CoV-2 due to its similarity with the severe acute respiratory syndrome (SARS) virus identified in 2002. The rapidly spreading infection was announced as a pandemic by the World Health Organization on March 11, 2020. The clinical symptoms of the disease have a wide range. The most common symptoms are fever, dry cough, myalgia or fatigue, and shortness of breath. The infectiousness of the virus is much higher than the CoVs described in previous years. It has also been reported that asymptomatic individuals can become infectious. The disease is generally diagnosed by performing reverse transcription-polymerase chain reaction test in nasopharyngeal swab samples. Direct X-ray and computed tomography are supportive of the diagnosis. Immune system functions play an important role in the prognosis of the disease. Chronic additional diseases are generally present in cases that result in death. Non-urgent examinations were postponed in forensic medicine outpatient clinics in COVID-19 infection. Forensic medicine specialists working in clinics and auxiliary personnel should be dressed following the standard personal protective equipment measures. Morgue workers should use at least FFP2 or N95 masks, face protection visors, plastic disinfectable boots, and waterproof gowns during post-mortem procedures in addition to standard measures, as they are considered to be in a very high-risk class. Firstly nasopharyngeal samples should be taken following the algorithms published by the council of forensic medicine and the result should be waited while making an autopsy decision during post-mortem examinations. In positive cases, if possible, a burial permit should be given with a death examination. Forensic cases should be performed in negative pressure salons if possible. Predominantly respiratory system pathologies such as diffuse alveolar damage, airway inflammation, pleurisy, pericarditis, lung consolidation, and pulmonary edema have been identified in the limited number of autopsy studies performed in COVID-19 infection.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
  • 1. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433.
  • 2. WHO. Novel coronavirus (2019-nCoV) situation report - 1 (21 January 2020).
  • 3. Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, evaluation, and treatment coronavirus (COVID-19). StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020.
  • 4. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020.
  • 5. WHO. Coronavirus disease (COVID-19) situation report - 133 (01 June 2020).
  • 6. Evren E, Us E. [COVID-19 Factor]. Memikoğlu O, Genç V, editörler. COVID-19. Ankara: Ankara Üniversitesi Basımevi; 2020. p.9-17.
  • 7. Lee FEH, Treanor JJ. Infectious diseases of the lungs, viral infections. In: Broaddus VC, Mason RJ, Ernst JD, King Jr TE, Lazarus SC, Murray JF, et al., eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia: Elsevier Saunders; 2016. p.527-57.
  • 8. Gerber SI, Watson JT. Coronaviruses. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia: Elsevier; 2020. p.2164-7.
  • 9. Cyranoski D. Profile of a killer: the complex biology powering the coronavirus pandemic. Nature. 2020;581(7806):22-6.
  • 10. WHO. Coronavirus disease 2019 (COVID-19) situation report - 73 (02 April 2020).
  • 11. Walls AC, Park YJ, Tortorici MA, Wall A, McGuire AT, Veesler D. Structure, function, and antigenicity of the SARS-CoV-2 spike glycoprotein. Cell. 2020;181(2):281-92.
  • 12. Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by the novel coronavirus from Wuhan: an analysis based on decadelong structural studies of SARS coronavirus. J Virol. 2020;94(7):e00127-20.
  • 13. Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res. 2020;7(1):1-10.
  • 14. Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect. 2020;104(3):246-51.
  • 15. van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and surface stability of SARS-CoV2 as compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564-7.
  • 16. Hanley B, Lucas SB, Youd E, Swift B, Osborn M. Autopsy in suspected COVID-19 cases. J Clin Pathol. 2020;73(5):239-42.
  • 17. CDC. Interim guidelines for collecting, handling, and testing clinical specimens from persons for coronavirus disease 2019 (COVID-19). 22 May 2020.
  • 18. Patel A, Jernigan DB; 2019-nCoV CDC Response Team. Initial public health response and interim clinical guidance for the 2019 novel coronavirus outbreak - United States, December 31, 2019-February 4, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(5):140-6.
  • 19. Uzun Ç. [Location of imaging and radiological findings]. Memikoğlu O, Genç V, editörler. COVID-19. Ankara: Ankara Üniversitesi Basımevi; 2020. p.35-43.
  • 20. Pan Y, Li X, Yang G, Fan J, Tang Y, Zhao J, et al. Serological immunochromatographic approach in diagnosis with SARS-CoV-2 infected COVID-19 patients. J Infect. 2020;81(1):e28-32.
  • 21. Qian GQ, Yang NB, Ding F, Ma AHY, Wang ZY, Shen YF, et al. Epidemiologic and clinical characteristics of 91 hospitalized patients with COVID-19 in Zhejiang, China: a retrospective, multi-centre case series. QJM. 2020;113(7):474-81.
  • 22. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.
  • 23. Raptis CA, Hammer MM, Short RG, Shah A, Bhalla S, Bierhals AJ, et al. Chest CT and coronavirus disease (COVID-19): a critical review of the literature to date. AJR Am J Roentgenol. 2020;215(4):839-42.
  • 24. do Nascimento IJB, Júnior I, Cacic N, Abdulazeem HM, von Groote TC, Jayarajah U, et al. Novel coronavirus infection (COVID-19) in humans: a scoping review and meta-analysis. J Clin Med. 2020;9(4):941.
  • 25. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
  • 26. Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020;77(6):683-90.
  • 27. Eliezer M, Hautefort C, Hamel AL, Verillaud B, Herman P, Houdart E, et al. Sudden and complete olfactory loss function as a possible symptom of COVID-19. JAMA Otolaryngol Head Neck Surg. 2020;146(7):674-5.
  • 28. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42.
  • 29. Chan JFW, Yuan S, Kok KH, To KKW, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514-23.
  • 30. Liu YC, Liao CH, Chang CF, Chou CC, Lin YR. A locally transmitted case of SARS-CoV-2 infection in Taiwan. N Engl J Med. 2020;382(11):1070-2.
  • 31. Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, et al. Transmission of 2019-nCoV infection from an asymptomatic contact in Germany. N Engl J Med. 2020;382(10):970-1.
  • 32. Zheng Z, Peng F, Xu B, Zhao J, Liu H, Peng J, et al. Risk factors of critical & mortal COVID19 cases: a systematic literature review and meta-analysis. J Infect. 2020;81(2):e16-25.
  • 33. Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020;92(6):552-5.
  • 34. Wang T, Du Z, Zhu F, Cao Z, An Y, Gao Y, et al. Comorbidities and multi-organ injuries in the treatment of COVID-19. Lancet. 2020;395(10228):e52.
  • 35. Carsetti R, Quintarelli C, Quinti I, Piano Mortari E, Zumla A, Ippolito G, et al. The immune system of children: the key to understanding SARS-CoV-2 susceptibility? Lancet Child Adolesc Health. 2020;4(6):414-6.
  • 36. Baud D, Qi X, Nielsen-Saines K, Musso D, Pomar L, Favre G. Real estimates of mortality following COVID-19 infection. Lancet Infect Dis. 2020;20(7):773.
  • 37. T.C. İçişleri Bakanlığı. Berber/Güzellik Salonu/Kuaförlerin Açılması. 21.3.2020 tarih ve 5759 sayılı genelgesi.
  • 38. T.C. İçişleri Bakanlığı. 65 Yaş ve Üzeri ile 20 Yaş Altı Vatandaşlar/Kişilerin Sokağa Çıkma Kısıtlaması İstisnası Hk. 21.3.2020 tarih ve 5762 sayılı genelgesi.
  • 39. T.C. İçişleri Bakanlığı. 65 Yaş ve Üzeri ile 20 Yaş Altı Vatandaşlar/Kişilerin Sokağa Çıkma Kısıtlaması İstisnası Hk. 3.4.2020 tarih ve 6235 sayılı genelgesi.
  • 40. Güvenlik görevlisine tüküren umreci müebbet ile yargılanabilir (9.4.2020).
  • 41. Kar H, Dokgöz H. Adli rapor. Dokgöz H, editör. Adli Tıp ve Adli Bilimler. 1. Baskı. Ankara: Akademisyen Kitabevi; 2019. p.359-78.
  • 42. Bilgin NG, Hilal A, Çekin N. İş kazaları, meslek hastalıkları ve maluliyet. Dokgöz H, editör. Adli Tıp ve Adli Bilimler. Ankara: Akademisyen Kitabevi; 2019. p.785-806.
  • 43. WHO. Coronavirus disease 2019 (COVID-19) situation report - 101 (30 April 2020).
  • 44. WHO. Infection prevention and control for the safe management of a dead body in the context of COVID-19. Interim guidance 24 March 2020.
  • 45. CDC. Collection and submission of postmortem specimens from deceased persons with known or suspected COVID-19 (4.6.2020).
  • 46. Osborn M, Lucas S, Stewart R, Swift B, Youd E. Briefing on COVID-19. Autopsy practice relating to possible cases of COVID-19 (2019-nCov, novel coronavirus from China 2019/2020). The Royal College of Pathologists. 2020
  • 47. Fineschi V, Aprile A, Aquila I, Arcangeli M, Asmundo A, Bacci M, et al; Scientific Society of Hospital Legal Medicine of the National Health System (COMLAS), Italian Society of Anatomical Pathology and Cytology (SIAPEC). Management of the corpse with suspect, probable or confirmed COVID-19 respiratory infection -Italian interim recommendations for personnel potentially exposed to material from corpses, including body fluids, in morgue structures and during autopsy practice. Pathologica. 2020;112(2):64-77.
  • 48. Barton LM, Duval EJ, Stroberg E, Ghosh S, Mukhopadhyay S. COVID-19 autopsies, Oklahoma, USA. Am J Clin Pathol. 2020;153(6):725-33.
  • 49. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8(4):420-2.
  • 50. Yao XH, Li TY, He ZC, Ping YF, Liu HW, Yu SC, et al. [A pathological report of three COVID-19 cases by minimally invasive autopsies]. Zhonghua Bing Li Xue Za Zhi. 2020;49(5):411-7.
  • 51. Schaller T, Hirschbühl K, Burkhardt K, Braun G, Trepel M, Märkl B, et al. Postmortem examination of patients with COVID-19. JAMA. 2020;323(24):2518-20.
  • 52. Fahrettin Koca: 7 bin 428 sağlık personeli virüse yakalandı (29.4.2020). [Link] 53. Lew E, Matshes E. Postmortem changes. In: Dolinak D, Matshes EW, Lew EO, eds. Forensic Pathology: Principles and Practice. 1st ed. Amsterdam: Elsevier Academic Press; 2005. p.528-54.
  • 54. Resmî Gazete (31.5.2006, Sayı: 5510), Sosyal Sigortalar ve Genel Sağlık Sigortası Kanunu.
APA EMİRAL E, Canturk N (2020). COVID-19 Enfeksiyonu ve Adli Tıp. , 282 - 291. 10.5336/forensic.2020-77074
Chicago EMİRAL Emrah,Canturk Nergis COVID-19 Enfeksiyonu ve Adli Tıp. (2020): 282 - 291. 10.5336/forensic.2020-77074
MLA EMİRAL Emrah,Canturk Nergis COVID-19 Enfeksiyonu ve Adli Tıp. , 2020, ss.282 - 291. 10.5336/forensic.2020-77074
AMA EMİRAL E,Canturk N COVID-19 Enfeksiyonu ve Adli Tıp. . 2020; 282 - 291. 10.5336/forensic.2020-77074
Vancouver EMİRAL E,Canturk N COVID-19 Enfeksiyonu ve Adli Tıp. . 2020; 282 - 291. 10.5336/forensic.2020-77074
IEEE EMİRAL E,Canturk N "COVID-19 Enfeksiyonu ve Adli Tıp." , ss.282 - 291, 2020. 10.5336/forensic.2020-77074
ISNAD EMİRAL, Emrah - Canturk, Nergis. "COVID-19 Enfeksiyonu ve Adli Tıp". (2020), 282-291. https://doi.org/10.5336/forensic.2020-77074
APA EMİRAL E, Canturk N (2020). COVID-19 Enfeksiyonu ve Adli Tıp. Türkiye Klinikleri Adli Tıp ve Adli Bilimler Dergisi, 17(3), 282 - 291. 10.5336/forensic.2020-77074
Chicago EMİRAL Emrah,Canturk Nergis COVID-19 Enfeksiyonu ve Adli Tıp. Türkiye Klinikleri Adli Tıp ve Adli Bilimler Dergisi 17, no.3 (2020): 282 - 291. 10.5336/forensic.2020-77074
MLA EMİRAL Emrah,Canturk Nergis COVID-19 Enfeksiyonu ve Adli Tıp. Türkiye Klinikleri Adli Tıp ve Adli Bilimler Dergisi, vol.17, no.3, 2020, ss.282 - 291. 10.5336/forensic.2020-77074
AMA EMİRAL E,Canturk N COVID-19 Enfeksiyonu ve Adli Tıp. Türkiye Klinikleri Adli Tıp ve Adli Bilimler Dergisi. 2020; 17(3): 282 - 291. 10.5336/forensic.2020-77074
Vancouver EMİRAL E,Canturk N COVID-19 Enfeksiyonu ve Adli Tıp. Türkiye Klinikleri Adli Tıp ve Adli Bilimler Dergisi. 2020; 17(3): 282 - 291. 10.5336/forensic.2020-77074
IEEE EMİRAL E,Canturk N "COVID-19 Enfeksiyonu ve Adli Tıp." Türkiye Klinikleri Adli Tıp ve Adli Bilimler Dergisi, 17, ss.282 - 291, 2020. 10.5336/forensic.2020-77074
ISNAD EMİRAL, Emrah - Canturk, Nergis. "COVID-19 Enfeksiyonu ve Adli Tıp". Türkiye Klinikleri Adli Tıp ve Adli Bilimler Dergisi 17/3 (2020), 282-291. https://doi.org/10.5336/forensic.2020-77074