Safe management of bodies of deceased persons with suspected or confirmed COVID-19: a rapid systematic review

Introduction Proper strategies to minimise the risk of infection in individuals handling the bodies of deceased persons infected with 2019 novel coronavirus (2019-nCoV) are urgently needed. The objective of this study was to systematically review the literature to scope and assess the effects of spe...

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Main Authors: Chen Chen, Holger J Schünemann, Antonio Bognanni, Elie A Akl, Guang Chen, Yuan Zhang, Karla Solo, Mark Loeb, Hong Zhao, Sally Yaacoub, Joanne Khabsa, Amena El-Harakeh, Assem M Khamis, Fatimah Chamseddine, Rayane El Khoury, Zahra Saad, Layal Hneiny, Carlos Cuello Garcia, Giovanna Elsa Ute Muti-Schünemann, Pierre Abi Hanna, Thomas Piggott, Marge Reinap, Nesrine Rizk, Rosa Stalteri, Stephanie Duda, Derek K Chu
Format: Article
Language:English
Published: BMJ Publishing Group 2020-05-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/5/5/e002650.full
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author Chen Chen
Holger J Schünemann
Antonio Bognanni
Elie A Akl
Guang Chen
Yuan Zhang
Karla Solo
Mark Loeb
Hong Zhao
Sally Yaacoub
Joanne Khabsa
Amena El-Harakeh
Assem M Khamis
Fatimah Chamseddine
Rayane El Khoury
Zahra Saad
Layal Hneiny
Carlos Cuello Garcia
Giovanna Elsa Ute Muti-Schünemann
Pierre Abi Hanna
Thomas Piggott
Marge Reinap
Nesrine Rizk
Rosa Stalteri
Stephanie Duda
Derek K Chu
author_facet Chen Chen
Holger J Schünemann
Antonio Bognanni
Elie A Akl
Guang Chen
Yuan Zhang
Karla Solo
Mark Loeb
Hong Zhao
Sally Yaacoub
Joanne Khabsa
Amena El-Harakeh
Assem M Khamis
Fatimah Chamseddine
Rayane El Khoury
Zahra Saad
Layal Hneiny
Carlos Cuello Garcia
Giovanna Elsa Ute Muti-Schünemann
Pierre Abi Hanna
Thomas Piggott
Marge Reinap
Nesrine Rizk
Rosa Stalteri
Stephanie Duda
Derek K Chu
author_sort Chen Chen
collection DOAJ
description Introduction Proper strategies to minimise the risk of infection in individuals handling the bodies of deceased persons infected with 2019 novel coronavirus (2019-nCoV) are urgently needed. The objective of this study was to systematically review the literature to scope and assess the effects of specific strategies for the management of the bodies.Methods We searched five general, three Chinese and four coronavirus disease (COVID-19)–specific electronic databases. We searched registries of clinical trials, websites of governmental and other relevant organisations, reference lists of the included papers and relevant systematic reviews, and Epistemonikos for relevant systematic reviews. We included guidance documents providing practical advice on the handling of bodies of deceased persons with suspected or confirmed COVID-19. Then, we sought primary evidence of any study design reporting on the efficacy and safety of the identified strategies in coronaviruses. We included evidence relevant to contextual factors (ie, acceptability). A single reviewer extracted data using a pilot-tested form and graded the certainty of the evidence using the GRADE approach. A second reviewer verified the data and assessments.Results We identified one study proposing an uncommon strategy for autopsies for patients with severe acute respiratory syndrome. The study provided very low-certainty evidence that it reduced the risk of transmission. We identified 23 guidance documents providing practical advice on the steps of handling the bodies: preparation, packing, and others and advice related to both the handling of the dead bodies and the use of personal protective equipment by individuals handling them. We did not identify COVID-19 evidence relevant to any of these steps.Conclusion While a substantive number of guidance documents propose specific strategies, we identified no study providing direct evidence for the effects of any of those strategies. While this review highlights major research gaps, it allows interested entities to build their own guidance.
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spelling doaj-art-10bb92d3f07b46beb46efb96c1460a9d2025-08-20T02:09:08ZengBMJ Publishing GroupBMJ Global Health2059-79082020-05-015510.1136/bmjgh-2020-002650Safe management of bodies of deceased persons with suspected or confirmed COVID-19: a rapid systematic reviewChen Chen0Holger J Schünemann1Antonio Bognanni2Elie A Akl3Guang Chen4Yuan Zhang5Karla Solo6Mark Loeb7Hong Zhao8Sally Yaacoub9Joanne Khabsa10Amena El-Harakeh11Assem M Khamis12Fatimah Chamseddine13Rayane El Khoury14Zahra Saad15Layal Hneiny16Carlos Cuello Garcia17Giovanna Elsa Ute Muti-Schünemann18Pierre Abi Hanna19Thomas Piggott20Marge Reinap21Nesrine Rizk22Rosa Stalteri23Stephanie Duda24Derek K Chu25Medical School of Nanjing University, Nanjing, Jiangsu Province, People’s Republic of Chinadepartment chairDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canadaassociate professorresearcherOphthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan, Guangzhou, Guangdong, Chinaclinical epidemiologist1 Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada1 Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China1 Clinical Research Institute, American University of Beirut, Beirut, Lebanonsenior research assistant1 Clinical Research Institute, American University of Beirut, Beirut, LebanonWolfson Palliative Care Research Centre, Hull York Medical School, Hull, UK1 Clinical Research Institute, American University of Beirut, Beirut, Lebanon1 Clinical Research Institute, American University of Beirut, Beirut, Lebanon5 Global Evidence Synthesis Initiative, American University of Beirut, Beirut, LebanonWegner Health Sciences Information Center, University of South Dakota, Sioux Falls, South Dakota, USA7 Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada8 Medical School, Vita Salute San Raffaele University, Milano, Italy12 Infectious Disease Division, Rafik Hariri University Hospital, Beirut, LebanonDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada14 London School of Hygiene and Tropical Medicine, London, UK15 Division of Infectious Diseases, American University of Beirut, Beirut, Lebanon7 Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada7 Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, CanadamethodologistIntroduction Proper strategies to minimise the risk of infection in individuals handling the bodies of deceased persons infected with 2019 novel coronavirus (2019-nCoV) are urgently needed. The objective of this study was to systematically review the literature to scope and assess the effects of specific strategies for the management of the bodies.Methods We searched five general, three Chinese and four coronavirus disease (COVID-19)–specific electronic databases. We searched registries of clinical trials, websites of governmental and other relevant organisations, reference lists of the included papers and relevant systematic reviews, and Epistemonikos for relevant systematic reviews. We included guidance documents providing practical advice on the handling of bodies of deceased persons with suspected or confirmed COVID-19. Then, we sought primary evidence of any study design reporting on the efficacy and safety of the identified strategies in coronaviruses. We included evidence relevant to contextual factors (ie, acceptability). A single reviewer extracted data using a pilot-tested form and graded the certainty of the evidence using the GRADE approach. A second reviewer verified the data and assessments.Results We identified one study proposing an uncommon strategy for autopsies for patients with severe acute respiratory syndrome. The study provided very low-certainty evidence that it reduced the risk of transmission. We identified 23 guidance documents providing practical advice on the steps of handling the bodies: preparation, packing, and others and advice related to both the handling of the dead bodies and the use of personal protective equipment by individuals handling them. We did not identify COVID-19 evidence relevant to any of these steps.Conclusion While a substantive number of guidance documents propose specific strategies, we identified no study providing direct evidence for the effects of any of those strategies. While this review highlights major research gaps, it allows interested entities to build their own guidance.https://gh.bmj.com/content/5/5/e002650.full
spellingShingle Chen Chen
Holger J Schünemann
Antonio Bognanni
Elie A Akl
Guang Chen
Yuan Zhang
Karla Solo
Mark Loeb
Hong Zhao
Sally Yaacoub
Joanne Khabsa
Amena El-Harakeh
Assem M Khamis
Fatimah Chamseddine
Rayane El Khoury
Zahra Saad
Layal Hneiny
Carlos Cuello Garcia
Giovanna Elsa Ute Muti-Schünemann
Pierre Abi Hanna
Thomas Piggott
Marge Reinap
Nesrine Rizk
Rosa Stalteri
Stephanie Duda
Derek K Chu
Safe management of bodies of deceased persons with suspected or confirmed COVID-19: a rapid systematic review
BMJ Global Health
title Safe management of bodies of deceased persons with suspected or confirmed COVID-19: a rapid systematic review
title_full Safe management of bodies of deceased persons with suspected or confirmed COVID-19: a rapid systematic review
title_fullStr Safe management of bodies of deceased persons with suspected or confirmed COVID-19: a rapid systematic review
title_full_unstemmed Safe management of bodies of deceased persons with suspected or confirmed COVID-19: a rapid systematic review
title_short Safe management of bodies of deceased persons with suspected or confirmed COVID-19: a rapid systematic review
title_sort safe management of bodies of deceased persons with suspected or confirmed covid 19 a rapid systematic review
url https://gh.bmj.com/content/5/5/e002650.full
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