Review: The safe handling of a corpse (suspected) with COVID-19.

INTRODUCTION: Countries around the world are confronted with a rising count of patients that die from COVID-19. Up to this date, there is no scientific evidence that proves that a COVID-19 corpse is still infectious. Different guidelines are being followed worldwide on how to deal with a COVID-19 positive corpse. The aim of this review is to compare different guidelines and literature on best practice for handling a COVID-19 positive corpse. RESULTS: The guidelines vary greatly in the use of PPE's and other safety measures especially during autopsy. There is great variation in the use of disinfectant and its concentration. Also recommended funeral services and contact with relatives vary greatly. CONCLUSION: In conclusion, there is very limited scientific evidence on which the researched guidelines are based. It is unclear why some guidelines propose a "business as usual" attitude and others a "code-red" attitude. More scientific evidence is needed to substantiate the handling of COVID-19 positive corpses to make an educated decision on how to safely handle a COVID-19 positive corpse.

Estimation of the postmortem interval based on the human decomposition process.

Postmortem interval (PMI) estimations which are used as evidence in Dutch court are sometimes solely based on the experience of the forensic physician without a scientific background. The aim of this study was to investigate the degree of agreement between forensic physicians and their PMI estimations. Fifteen cases were selected from 1534 external postmortem investigations. Photographs of the human remains were presented to 89 forensic physicians in the Netherlands with the instruction to estimate the PMI based on their experience, knowing the remains were found indoors and in which season. Data analysis was conducted by using an interclass correlation (ICC) and Spearman's rank correlation coefficient. This study shows a poor correlation (ICC = 0.254) between the PMI estimations of the 89 forensic physicians. It is therefore not advised that PMI estimations based on experience be used as evidence in court.

The development of a post-mortem interval estimation for human remains found on land in the Netherlands.

The decomposition process of human remains can be used to estimate the post-mortem interval (PMI), but decomposition varies due to many factors. Temperature is believed to be the most important and can be connected to decomposition by using the accumulated degree days (ADD). The aim of this research was to develop a decomposition scoring method and to develop a formula to estimate the PMI by using the developed decomposition scoring method and ADD.A decomposition scoring method and a Book of Reference (visual resource) were made. Ninety-one cases were used to develop a method to estimate the PMI. The photographs were scored using the decomposition scoring method. The temperature data was provided by the Royal Netherlands Meteorological Institute. The PMI was estimated using the total decomposition score (TDS) and using the TDS and ADD. The latter required an additional step, namely to calculate the ADD from the finding date back until the predicted day of death.The developed decomposition scoring method had a high interrater reliability. The TDS significantly estimates the PMI (R 2 = 0.67 and 0.80 for indoor and outdoor bodies, respectively). When using the ADD, the R 2 decreased to 0.66 and 0.56.The developed decomposition scoring method is a practical method to measure decomposition for human remains found on land. The PMI can be estimated using this method, but caution is advised in cases with a long PMI. The ADD does not account for all the heat present in a decomposing remain and is therefore a possible bias.