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We examined 29 autopsy cases (investigated between October 2020 and February 2021) whose postmortem swabs tested positive for SARS-CoV-2. Twenty-two of 29 cases died while hospitalized (H), while the remaining 7 cases were not hospitalized (NH). Since we included only cases in which the time since death was known (excluding unwitnessed NH deaths), the interval between death and postmortem swab(s) was registered, with a mean NH value of 5.50 days and a mean H value of 3.98 days. The mean age of NH was 65 years, while H were older (mean age: 73 years). Twenty-eight nasopharyngeal and 27 lungs postmortem swabs were obtained and real-time reverse transcriptase‒polymerase chain reaction assay for total and replicative SARS-CoV-2 RNA and mRNA detection was performed. Although the mean death-postmortem swabs interval was higher in NH than in H, the mean viral load of NH was higher than that of H (2.53 × 10 11 copies/mL vs 9.31 × 10 8 copies/mL). In 13/29 cases (6 NH and 7 H), indicators of active replication were found. The relationship between the presence of replicative mRNA and death without hospitalization and that between the minimum cycle threshold value of SARS-CoV-2 RNA and the cycle threshold value of replicative SARS-CoV-2 mRNA were found to be statistically significant (with respective P values of 0.013 and 0.000). Therefore, especially in NH, full compliance with guidelines on biological safety in the autopsy room is essential, and no autopsy can be performed on infected cases in a structure that does not meet the established safety criteria.

Titel:	SARS-CoV-2 viral load and replication in postmortem examinations.
Autor/in / Beteiligte Person:	Grassi, S ; Arena, V ; Cattani, P ; Dell'Aquila, M ; Liotti, FM ; Sanguinetti, M ; Oliva, A
Zeitschrift:	International journal of legal medicine, Jg. 136 (2022-05-01), Heft 3, S. 935-939
Veröffentlichung:	Heidelberg, FRG : Springer International, c1990-, 2022
Medientyp:	academicJournal
ISSN:	1437-1596 (electronic)
DOI:	10.1007/s00414-021-02753-2
Schlagwort:	Aged Autopsy Humans RNA, Messenger RNA, Viral Viral Load COVID-19 diagnosis SARS-CoV-2
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Corporate Authors: GEMELLI AGAINST COVID-19 group Publication Type: Journal Article Language: English [Int J Legal Med] 2022 May; Vol. 136 (3), pp. 935-939. <i>Date of Electronic Publication: </i>2022 Jan 24. MeSH Terms: COVID-19* / diagnosis ; SARS-CoV-2* ; Aged ; Autopsy ; Humans ; RNA, Messenger ; RNA, Viral ; Viral Load References: Sperhake J-P (2020) Autopsies of COVID-19 deceased? Absolutely! Legal Med 47. https://doi.org/10.1016/j.legalmed.2020.101769. ; Aguiar D, Lobrinus JA, Schibler M et al (2020) Inside the lungs of COVID-19 disease. Int J Legal Med 134. https://doi.org/10.1007/s00414-020-02318-9. ; Barth RF, Xu X, Buja LM (2020) A call to action. Chest 158. https://doi.org/10.1016/j.chest.2020.03.060. ; Oliva A, Caputo M, Grassi S et al (2020) Liability of health care professionals and institutions during COVID-19 pandemic in Italy: symposium proceedings and position statement. 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SARS-CoV-2 viral load and replication in postmortem examinations.