Impact of Covid-19 lockdown on characteristics of autopsy cases in Greece. Comparison between 2019 and 2020

Abstract

In order to reduce transmission of COVID-19, social distancing measures were proposed, including spatial distancing (2 m distance), or even generalized lockdown. Main concern was to prevent overwhelming of the healthcare systems, mainly of the intensive care units (ICUs) by decreasing the spreading of the disease. In Greece, the Government, after consulting with experts in the fields of infectious disease and epidemiology, implemented a rather aggressive stance with an early lockdown.Aim of our study, is to identify and compare the characteristics of cases referred for autopsy during the first month of the lockdown period for the COVID-19 outbreak, versus the cases referred during the same period in 2019.231 autopsy cases were included in our study, 125 in 2019 and 106 in 2020. Regarding gender, age and nationality, no significant differences were detected between the two time periods. Age subgroup analysis demonstrated increased number of cases within the age group 70-79 years, in 2020.As to the place of death, the increase in the percentage of out-of-hospital deaths was not confirmed as statistically significant. Regarding type of death (violent, sudden/unexpected), the drop of violent deaths in the 2020 examined period, was not confirmed as statistically significant; however, further subgroup analysis showed a significant drop of fatal injuries resulting from road traffic accidents in the 2020 period. The slight increase of sudden/unexpected deaths, especially myocardial infarction cases, did not reach statistical significance.One month after lockdown, we cannot detect significant differences in the two time periods examined. Further study should be conducted soon when more data will become available. Frequency of fatal myocardial infarction seems to remain unaffected by the COVID-19 pandemic while deaths resulting from road traffic accidents exhibit a significant decrease. Homicides and suicides remain at low levels, in our jurisdiction area, seemingly unaffected by the COVID-19 outbreak and the subsequent lockdown.It appears that since sudden/unexpected deaths, statistically remain unaffected, the preventive measures taken by the Greek authorities prevented overwhelming of the healthcare system, which could function properly.

Trends in suicide rates during the COVID-19 pandemic restrictions in a major German city

“…It illustrates, however, that suicide rates will not increase immediately, but possibly only with a time lag. This is consistent with studies reporting no increase in suicidal behaviour, used as an indirect measure for suicide risk, in the early stages of the COVID-19 pandemic [31][32][33][34][35][36][37] .…”

“…For instance, online surveys showed a decrease in suicidal thoughts and intention during the pandemic; presentation at emergency departments due to suicidal ideation decreased , suicides in selective autopsy samples remained low 37 , and search engine users entered suicide-related terms less frequently [31][32][33]35 . However, the overall results are inhomogeneous, since other surveys indicate a high prevalence of suicidal thoughts during the pandemic, in particular under quarantine conditions 3,[38][39][40][41] .…”

Trends in suicide rates during the COVID-19 pandemic restrictions in a major German city

“…Our results are consistent with studies reporting no increase in suicidal behaviour, which is used as an indirect measure for suicide risk (Halford et al, 2020;Hamm et al, 2020;Jacobson et al, 2020;Knipe et al, 2020;Sakelliadis et al, 2020;Sinyor et al, 2020;Smalley et al, 2020). For instance, online surveys showed a decrease in suicidal thoughts and intention during the pandemic; presentation at emergency departments due to suicidal ideation decreased (Smalley et al, 2020), suicides in selective autopsy samples remained low (Sakelliadis et al, 2020), and search engine users entered suicide-related terms less frequently (Halford et al, 2020;Jacobson et al, 2020;Knipe et al, 2020;Sinyor et al, 2020). However, the overall results are inhomogeneous, since other surveys indicate a high prevalence of suicidal thoughts during the pandemic, in particular under quarantine conditions (Fitzpatrick et al, 2020;Gratz et al, 2020;Patsali et al, 2020).…”

Analysis of Road Traffic Accident Fatalities in Karachi, Pakistan: An Autopsy-Based Study

“…Preventive measures, such as staying at home, were also taken by people so that they could protect themselves from contracting the virus. There was a decrease in RTA injuries and fatalities in Ireland [22] and Greece [23] because of the COVID-19 burden and the restrictions imposed. COVID-19 may have impacted RTA fatalities in Pakistan as well.…”