TY - JOUR T1 - Coronial postmortem reports and indirect COVID-19 pandemic-related mortality JF - Journal of Clinical Pathology JO - J Clin Pathol DO - 10.1136/jclinpath-2021-208003 SP - jclinpath-2021-208003 AU - Robert Pell AU - S Kim Suvarna AU - Nigel Cooper AU - Guy Rutty AU - Anna Green AU - Michael Osborn AU - Peter Johnson AU - Alison Hayward AU - Justine Durno AU - Theodore Estrin-Serlui AU - Marion Mafham AU - Ian S D Roberts Y1 - 2022/01/15 UR - http://jcp.bmj.com/content/early/2022/01/16/jclinpath-2021-208003.abstract N2 - Aims Widespread disruption of healthcare services and excess mortality not directly attributed to COVID-19 occurred between March and May 2020. We undertook the first UK multicentre study of coroners’ autopsies before and during this period using postmortem reports.Methods We reviewed reports of non-forensic coroners’ autopsies performed during the first COVID-19 lockdown (23 March to 8 May 2020), and the same period in 2018. Deaths were categorised as natural non-COVID-19, COVID-19-related, non-natural (suicide, drug and alcohol-related, traumatic, other). We provided opinion regarding whether delayed access to medical care or changes in behaviour due to lockdown were a potential factor in deaths.Results Seven centres covering nine coronial jurisdictions submitted a total of 1100 coroners’ autopsies (498 in 2018, 602 in 2020). In only 54 autopsies was death attributed to COVID-19 (9%). We identified a significant increase in cases where delays in accessing medical care potentially contributed to death (10 in 2018, 44 in 2020). Lockdown was a contributing factor in a proportion of suicides (24%) and drug and alcohol-related deaths (12%).Conclusions Postmortem reports have considerable utility in evaluating excess mortality due to healthcare and wider societal disruption during a pandemic. They provide information at an individual case level that is not available from assessment of death certification data. Detailed evaluation of coroners’ autopsy reports, supported by appropriate regulatory oversight, is recommended to mitigate disruption and indirect causes of mortality in future pandemics. Maintaining access to healthcare, including substance misuse and mental health services, is an important consideration.All data relevant to the study are included in the article. ER -