Turkiye Klinikleri Journal of Forensic Medicine and Forensic Sciences

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Covid-19 Enfeksiyonu ve Adli Tıp
Covid-19 Infection and Forensic Medicine
Emrah EMİRALa, Nergis CANTÜRKb
aAnkara Üniversitesi Tıp Fakültesi Adli Tıp ABD, Ankara TÜRKİYE
bAnkara Üniversitesi Adli Bilimler Enstitüsü, Ankara TÜRKİYE
Turkiye Klinikleri J Foren Sci Leg Med. 2020;17(3):282-91
doi: 10.5336/forensic.2020-77074
Article Language: TR
Full Text
ÖZET
 Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] enfeksiyonu; 2019 yılı Aralık ayında, Çin'in Hubei eyaletinin Wuhan şehrinde ilk kez tanımlanmıştır. Etken virüs, 2002 yılında tanımlanan şiddetli akut solunum sendromu [severe acute respiratory syndrome (SARS)] virüsü ile benzerliği sebebiyle SARSCoV-2 olarak isimlendirilmiştir. Hızla yayılan enfeksiyon, 11 Mart 2020 tarihinde Dünya Sağlık Örgütü tarafından pandemi olarak duyurulmuştur. Hastalığın klinik belirtileri, oldukça geniş bir yelpazede seyretmektedir. En sık görülen semptomlar ateş, kuru öksürük, miyalji veya yorgunluk ile nefes darlığıdır. Virüsün bulaşıcılığı, önceki yıllarda tanımlanan CoV'lere oranla çok daha yüksektir. Asemptomatik kişilerin, bulaştırıcı olabileceği de bildirilmiştir. Hastalık tanısı, genellikle nazofarengeal sürüntü örneklerine revers transkripsiyon-polimeraz zincir reaksiyonu testi yapılarak konulmaktadır. Direkt grafi ve bilgisayarlı tomografi, tanıda destekleyicidir. Hastalığın prognozunda, immün sistem fonksiyonları önemli rol oynamaktadır. Ölümle sonuçlanan olgularda, genellikle kronik ek hastalıklar mevcuttur. COVID-19 enfeksiyonunda, adli tıp polikliniklerinde acil olmayan muayeneler ertelenmiştir. Kliniklerde çalışan adli tıp uzmanı ve yardımcı personel, standart kişisel koruyucu ekipman önlemlerine uygun giyinmelidir. Postmortem işlemler sırasında morg çalışanları, çok yüksek riskli sınıfta kabul edildiğinden standart önlemlere ek olarak en az FFP2 ya da N95 maske, yüz koruyucu siperlik, plastik dezenfekte edilebilir çizme ve su geçirmez önlük kullanmalıdır. Postmortem incelemeler sırasında otopsi kararı verilirken, adli tıp kurumunun yayımladığı algoritmalara uygun olarak öncelikle nazofarengeal örnek alınarak sonucu beklenmelidir. Pozitif olgularda, mümkünse ölü muayenesi ile defin ruhsatı verilmelidir. Adli olgulara otopsi, mümkünse negatif basınçlı salonlarda yapılmalıdır. COVID-19 enfeksiyonunda yapılan sınırlı sayıdaki otopsi çalışmalarında; yaygın alveoler hasar, havayolu inflamasyonu, plörezi, perikardit, akciğer konsolidasyonu ve pulmoner ödem gibi ağırlıklı olarak solunum sistemi patolojileri saptanmıştır.

Anahtar Kelimeler: COVID-19; adli tıp; otopsi; primer korunma
ABSTRACT
 Coronavirus disease-2019 (COVID-19) infection was first described in the city of Wuhan in the Hubei province of China in December 2019. The causative virus was named SARS-CoV-2 due to its similarity with the severe acute respiratory syndrome (SARS) virus identified in 2002. The rapidly spreading infection was announced as a pandemic by the World Health Organization on March 11, 2020. The clinical symptoms of the disease have a wide range. The most common symptoms are fever, dry cough, myalgia or fatigue, and shortness of breath. The infectiousness of the virus is much higher than the CoVs described in previous years. It has also been reported that asymptomatic individuals can become infectious. The disease is generally diagnosed by performing reverse transcription-polymerase chain reaction test in nasopharyngeal swab samples. Direct X-ray and computed tomography are supportive of the diagnosis. Immune system functions play an important role in the prognosis of the disease. Chronic additional diseases are generally present in cases that result in death. Non-urgent examinations were postponed in forensic medicine outpatient clinics in COVID-19 infection. Forensic medicine specialists working in clinics and auxiliary personnel should be dressed following the standard personal protective equipment measures. Morgue workers should use at least FFP2 or N95 masks, face protection visors, plastic disinfectable boots, and waterproof gowns during post-mortem procedures in addition to standard measures, as they are considered to be in a very high-risk class. Firstly nasopharyngeal samples should be taken following the algorithms published by the council of forensic medicine and the result should be waited while making an autopsy decision during post-mortem examinations. In positive cases, if possible, a burial permit should be given with a death examination. Forensic cases should be performed in negative pressure salons if possible. Predominantly respiratory system pathologies such as diffuse alveolar damage, airway inflammation, pleurisy, pericarditis, lung consolidation, and pulmonary edema have been identified in the limited number of autopsy studies performed in COVID-19 infection.

Keywords: COVID-19; forensic medicine; autopsy; primary prevention
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4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com