[Development and progress of the National Autopsy Network (NATON)].

Abstract

Autopsies have long been considered the gold standard for quality assurance in medicine, yet their significance in basic research has been relatively overlooked. The COVID-19 pandemic underscored the potential of autopsies in understanding pathophysiology, therapy, and disease management. In response, the German Registry for COVID-19 Autopsies (DeRegCOVID) was established in April 2020, followed by the DEFEAT PANDEMIcs consortium (2020-2021), which evolved into the National Autopsy Network (NATON). DeRegCOVID collected and analyzed autopsy data from COVID-19 deceased in Germany over three years, serving as the largest national multicenter autopsy study. Results identified crucial factors in severe/fatal cases, such as pulmonary vascular thromboemboli and the intricate virus-immune interplay. DeRegCOVID served as acentral hub for data analysis, research inquiries, and public communication, playing avital role in informing policy changes and responding to health authorities. Initiated by the Network University Medicine (NUM), NATON emerged as asustainable infrastructure for autopsy-based research. NATON aims to provide adata and method platform, fostering collaboration across pathology, neuropathology, and legal medicine. Its structure supports aswift feedback loop between research, patient care, and pandemic management. DeRegCOVID has significantly contributed to understanding COVID-19 pathophysiology, leading to the establishment of NATON. The National Autopsy Registry (NAREG), as its successor, embodies amodular and adaptable approach, aiming to enhance autopsy-based research collaboration nationally and, potentially, internationally.