How Long Can a Dead Body Remain Infectious?: Postmortem Nasopharyngeal Swabs and SARS-CoV-2 Culture in a Corpse Over an 87-Day Period.

ABSTRACT: The SARS-CoV-2 pandemic involved several changes and difficulties in the work of forensic pathologists. Postmortem nasopharyngeal swabs for the diagnosis of the SARS-CoV-2 infection are recommended before an autopsy examination by the Centers for Disease Control and Prevention.Autopsy examinations must not be performed for SARS-CoV-2 infection cases when airborne infection isolation rooms or other suitable spaces are unavailable. However, it has not yet been reported whether the presence of SARS-CoV-2 at a low viral load may be enough to infect and disseminate the contagion.Here, we report the case of a 67-year-old man found dead at home on November 9, 2020, and transferred immediately after to the Genova District Mortuary. As the first postmortem molecular nasopharyngeal swab resulted positive, a weekly sampling was carried until February 4, 2021. All the molecular tests were positive for SARS-CoV-2, including the last swab performed 87 days after the arrival of the corpse at the morgue. Virus isolation conducted on VERO E6 cells revealed no cytopathic effect indicating no viral replication as early as 18 days after the corpse's arrival at the morgue and until January 2021.Our findings suggest that the presence of the genome of SARS-CoV-2 at low viral load should not be considered a sign of an active infection but a trace of a remaining viral genome from a previous infection. Then, if the virus shows no replication activity, its molecular detection should not constitute a threat to public health. Further studies are required to establish the infection's potential and its correlation with viral load.

Postmortem nasopharyngeal swabs performed during the COVID-19 infection: Analysis of preliminary clinical records by the genoa institute of legal medicine (North-West Italy)

COVID-19, the disease caused by the SARS-CoV-2 virus, is highly contagious. The persistence of the virus after infected individuals die remains unclear. This article reports the findings taken from postmortem nasopharyngeal swabs performed to investigate the presence of SARS-CoV-2 in the corpses transferred to the Genoa District Mortuary from the outset of the Italian lockdown (March 9) to the end of the first emergency phase (July 13). One hundred and eighty swabs were carried out: 13 corpses resulted positive for the virus, with the diagnosis being reached only after death. Seven were male and 6 female with an average age of 73.5 years old. The most frequent comorbidities recorded were arterial hypertension, diabetes, Alzheimer's, and pulmonary disease. In two cases, the swab tested positive at a distance of 125 h and 165 h from actual death. The nasopharyngeal swab results a useful way to screen corpses for COVID-19 and to handle bodies in Legal Medicine Centers where safe autoptic rooms are not available. Swabs are also a means of safeguarding forensic pathologists, identifying the presence of breeding grounds in the community and providing information for the Public Prosecutor's Office in legal cases. They are able to produce reliable results up to at least 7 days following death, provided that the corpse is correctly preserved.

COVID-19 in the tonsillectomised population.

OBJECTIVE: Interactions between SARS-CoV-2 and pharyngeal associated lymphoid tissue are thought to influence the manifestations of COVID-19. We aimed to determine whether a previous history of tonsillectomy, as a surrogate indicator of a dysfunctional pharyngeal associated lymphoid tissue, could predict the presentation and course of COVID-19. METHODS: Multicentric cross-sectional observational study involving seven hospitals in Northern and Central Italy. Data on the clinical course and signs and symptoms of the infection were collected from 779 adults who tested positive for SARS-CoV-2, and analysed in relation to previous tonsillectomy, together with demographic and anamnestic data. RESULTS: Patients with previous tonsillectomy showed a greater risk of fever, temperature higher than 39°C, chills and malaise. No significant differences in hospital admissions were found. CONCLUSIONS: A previous history of tonsillectomy, as a surrogate indicator of immunological dysfunction of the pharyngeal associated lymphoid tissue, could predict a more intense systemic manifestation of COVID-19. These results could provide a simple clinical marker to discriminate suspected carriers and to delineate more precise prognostic models.