A call for study of lung tissues of patients who die of Covid-19 by conducting postmortem biopsies has found no takers in Karnataka, primarily due to complications involved in dealing with contagion deaths.
To understand the disease’s progression in the lungs, which is the primary organ damaged by coronavirus, a provision for conducting lung biopsies in patients who die due to Covid has been made by the Rajiv Gandhi University of Health Sciences in Karnataka and the Indian Council for Medical Research but no proposals have been made so far, said officials.
“We have made a provision for anybody who wants to take up the study of lung damage in Covid-19 death cases. There have been no proposals so far,” said Rajiv Gandhi University of Health Sciences vice-chancellor Dr S Sachidananda.
“The RGUHS has called for study proposals with biopsies of the lungs but no researcher has come forward to conduct research,” the Karnataka health commissioner Pankay Pandey said. Since March 10 there have been 44 Covid-19 deaths in Karnataka but no samples of tissues from organs such as lungs and heart have been collected. An autopsy was conducted only in one case of unnatural death of a Covid-19 patient who committed suicide at the hospital where he was admitted.
Biopsies are medical procedures where cells and tissues in the body are extracted to study the nature of a disease and its progression in an organ or body. Since the outbreak of the Covid pandemic, several studies have been conducted using lung samples in parts of the world, including China. One of the Chinese studies looking at the lung tissues of Covid 19 victims — published in the science journal Nature by researchers from the Zhongnan Hospital of Wuhan University — showed that gas exchange surfaces in the lungs that keep the blood oxygenated and facilitate breathing were extensively damaged.
The ICMR, which recently published “Standard guidelines for medico-legal autopsy in Covid 19 deaths in India” has outlined the need for research on the effects of the coronavirus in lungs and other organs of the human body.
One of the issues affecting research on lung samples from coronavirus victims is safety. The Karnataka health department had issued standard operating procedures for conducting postmortem examination on victims of Covid-19. It states that forensic experts should conduct invasive autopsies only in the case of unnatural deaths of persons who test positive for Covid 19.
“It is not easy to obtain samples of the lung tissue in cases of Covid-19 deaths and a great deal of caution has to be exercised by doctors. There are also ethical issues like obtaining the consent of the families of victims. As a result no one is probably keen to conduct lung or other biopsies for research purposes,” a professor at the Bangalore Medical College and Research Institute said.
According to the ICMR’s guidelines, “pathological autopsy for research” purposes on Covid 19 victims can be conducted only after “proper ethical clearance from respective institute” and as per guidelines of ICMR and health authorities. “The informed consent and other ethical aspects like confidentiality, religious sentiments etc. should be addressed as per the specific objectives and methodology,” ICMR has stated.
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