Forensic Medicine in the Time of COVID-19: Preliminary Results, Innovative Solutions and Unanswered Questions

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Coronaviruses (CoV) and COVID-19 Pandemic".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 8257

Special Issue Editor

SC (UCO) Forensic Medicine, Giuliano Isontina University Health Authority (ASU GI), 34128 Trieste, Italy
Interests: Covid-19; autopsy; immunohistochemistry; post-mortem examination; forensic pathology; forensic science; Covid-19 diagnostics, clinical risk management, medical liability, ethical and legal issues
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Special Issue Information

Dear Colleagues,

The COVID-19 (coronavirus disease-19) remains the most urgent health emergency worldwide and all professionals have been called to give support in the diagnosis and treatment of patients affected by this disease. Despite early concerns about safety, forensic medicine has contributed to a better understanding of the pathological mechanisms of the disease and support the evaluation and management of surviving patients. Forensic scientific communities were involved with recommendations for safety measures and corpses management in order to contain the risk of infection during autopsies. A standardized sampling methodology was early shared between pathologists as well as post mortem swabs collecting and processing. Despite these efforts and the high number of deaths worldwide, the post mortem investigation rate still remains extremely low and the panel of postmortem investigation varied among authors according to availability and resources. The role and weight of comorbidities to the mechanism of death need to be emphasized, morphological features of COVID-19 infection completely investigated, physiopathology of infection and causes of death deeply explained, as well as the role of proinflammatory cytokines.

On the other hand, nosocomial COVID-19 infection or outbreak of the disease in community settings in elderly people with comorbidities involved healthcare providers with medical liability. Healthcare organizations’ responses to the pandemic, the management of infected patients and clinical risk management strategies to contain the risk of infection may present the a new challenge for clinical–forensic medicine.

The purpose of this Special Issue is to encourage the presentation of single/multicentre experience with COVID-19 infection in the field of forensic medicine, healthcare organizations and clinical risk management. It is open to the submission of manuscripts, reviews, research, short communications, reports that can contribute to the debate of the actual role of forensic medicine in the pandemic.

Prof. Stefano D’Errico
Guest Editor

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Keywords

  • Covid-19 infection
  • autopsy
  • covid-19 vaccination
  • medical liability
  • clinical risk management

Published Papers (2 papers)

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Research

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9 pages, 238 KiB  
Communication
Controversies and Challenges of Mass Vaccination against SARS-CoV-2 in Italy: Medico-Legal Perspectives and Considerations
by Rosario Barranco, Gabriele Rocca, Andrea Molinelli and Francesco Ventura
Healthcare 2021, 9(9), 1163; https://doi.org/10.3390/healthcare9091163 - 05 Sep 2021
Cited by 12 | Viewed by 2635
Abstract
The worldwide spread of SARS-CoV-2 and the pandemic has resulted in a serious global crisis in the health, social and economic spheres. After an initial period of enthusiasm related to the efficacy of vaccines, in many European countries, a growing distrust in the [...] Read more.
The worldwide spread of SARS-CoV-2 and the pandemic has resulted in a serious global crisis in the health, social and economic spheres. After an initial period of enthusiasm related to the efficacy of vaccines, in many European countries, a growing distrust in the population has matured, due to the reporting of severe adverse effects. Throughout the world, some cases of adverse events after the administration of the vaccine have been reported. In this communication, we want to discuss all the medico-legal aspects related to the global vaccination companion in terms of medical professional responsibility, informed consent and vaccination obligation, with particular attention to the Italian situation. Health professionals are tasked with promoting confidence in vaccination for the general population. Complete and detailed information and reliance on scientific research is essential to understand the great importance of the vaccination campaign. From a criminal point of view, we must avoid blaming health professionals in the case of side effects. At the same time, we must protect the population, ensuring compliance with the indications, guidelines, and an adequate method of administration. On the other hand, from a civil law perspective, it is correct to ensure full protection of those rare cases in which the administration of the vaccine is related to adverse events. Without a broad and global vaccination campaign, it will be impossible to overcome COVID-19. Full article

Review

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16 pages, 5945 KiB  
Review
The Impact of the COVID-19 Pandemic on the Practice of Forensic Medicine: An Overview
by Massimiliano Esposito, Monica Salerno, Edmondo Scoto, Nunzio Di Nunno and Francesco Sessa
Healthcare 2022, 10(2), 319; https://doi.org/10.3390/healthcare10020319 - 08 Feb 2022
Cited by 15 | Viewed by 3952
Abstract
During the COVID-19 pandemic, forensic sciences, on the one hand, contributed to gaining knowledge about different aspects of the pandemic, while on the other hand, forensic professionals were called on to quickly adapt their activities to respond adequately to the changes imposed by [...] Read more.
During the COVID-19 pandemic, forensic sciences, on the one hand, contributed to gaining knowledge about different aspects of the pandemic, while on the other hand, forensic professionals were called on to quickly adapt their activities to respond adequately to the changes imposed by the pandemic. This review aims to clarify the state of the art in forensic medicine at the time of COVID-19, discussing the following: the influence of external factors on forensic activities, the impact of autopsy practice on COVID-19 and vice-versa, the persistence of SARS-CoV-2 RNA in post-mortem samples, forensic personnel activities during the SARS-CoV-2 pandemic, the global vaccination program and forensic sciences, forensic undergraduate education during and after the imposed COVID-19 lockdown, and the medico-legal implications in medical malpractice claims during the COVID-19 pandemic. The COVID-19 pandemic has greatly influenced different aspects of human life, and, accordingly, the practical activities of forensic sciences that are defined as multidisciplinary, involving different expertise. Indeed, the activities are very different, including crime scene investigation (CSI), external examination, autopsy, and genetic and toxicological examinations of tissues and/or biological fluids. At the same time, forensic professionals may have direct contact with subjects in life, such as in the case of abuse victims (in some cases involving children), collecting biological samples from suspects, or visiting subjects in the case of physical examinations. In this scenario, forensic professionals are called on to implement methods to prevent the SARS-CoV-2 infection risk, wearing adequate PPE, and working in environments with a reduced risk of infection. Consequently, in the pandemic era, the costs involved for forensic sciences were substantially increased. Full article
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