A recent autopsy study conducted in Switzerland has revealed a significant underreporting of COVID-19 cases and deaths. The study aimed to address the question of whether individuals who died with fatal outcomes truly died from COVID-19 or with the presence of the SARS-CoV-2 virus. The findings shed light on the accurate estimation of COVID-19 mortality and the potential impact of underreporting on mortality rates.
The study analyzed lung tissues from 62 consecutive autopsies conducted during the first and second waves of the pandemic in Switzerland. The majority of the deceased patients had comorbidities such as chronic cardiovascular disease, hypertension, and chronic respiratory disease. The most common cause of death was respiratory failure due to pneumonia or acute cardiovascular events.
The crucial findings of the study revealed a significant discrepancy between the reported COVID-19 cases during the patients’ lifetimes and the post-mortem detection of SARS-CoV-2 in their lung tissues. Among the 62 autopsy cases, only 18 patients were clinically diagnosed with COVID-19 before death, representing just 29% of the cohort. However, post-mortem analysis detected SARS-CoV-2 in the lung tissues of 28 patients, indicating an underreporting rate of 16%. Additionally, five patients who were unexpectedly SARS-CoV-2 positive exhibited typical COVID-19 symptoms and autopsy findings consistent with the disease, highlighting the challenges in accurately diagnosing COVID-19 during patients’ lifetimes.
The autopsy results revealed an 8% higher SARS-CoV-2-related mortality rate than officially reported. While clinicians reported COVID-19 in 29% of cases, the autopsy findings suggested that 37% of all cases had a cause of death directly related to SARS-CoV-2 infection. This difference emphasized the potential contribution of underreporting to the excess mortality rates observed during the pandemic.
Further analysis of the autopsy data showed that only 25% of COVID-19 deaths had bacterial co-infections in the lungs, highlighting the importance of understanding the incidence of superinfections in critically ill patients. The study also explored the histomorphological appearance of autopsy lungs in clinically known COVID-19 patients and those identified post-mortem, revealing differences in the characteristic lung damage observed.
The study’s findings underscore the complexity of accurately assessing the true impact of the virus on mortality rates. Factors contributing to the underreporting of COVID-19 cases include low viral copy numbers in the nose, atypical or asymptomatic infection courses, insufficient testing capacities, and analytical vulnerabilities in diagnostic testing.
The implications of underreported COVID-19 cases and deaths extend beyond scientific curiosity and have significant implications for public health policies, resource allocation, and the overall understanding of the pandemic’s true toll. The study advocates for the continued utilization of autopsies in understanding infectious diseases, particularly during pandemics, and calls for a reevaluation of testing strategies and reporting mechanisms to ensure a more accurate representation of the true prevalence of SARS-CoV-2 within populations.
The Swiss autopsy study serves as a significant contribution to the global discourse on the true impact of the virus. It highlights the crucial role of autopsies in unraveling the mysteries of infectious diseases and calls for a comprehensive understanding of the pandemic’s toll on human lives. Ultimately, this understanding is essential for shaping effective public health responses, fostering resilience in healthcare systems, and preparing for future pandemics.