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Introduction Without a comprehensive postmortem investigation it is impossible to determine the cause of death among the SARS-CoV-2-suspected and-positive patients. We present two cases to discuss the postmortem detectability of SARS-CoV-2 virus and RNA stability in biological samples. Outline of cases Case No. 1: a 40-year-old man on whom the autopsy was performed four days after death. The body was stored at 4°C. Bilateral pneumonia was confirmed grossly and histopathologicaly. Molecular testing was positive for IgM antibodies, but negative for SARS-CoV-2 RNA. Case No. 2: a 28-year-old profes-sional basketball player who suffered from SARS-CoV-2 about a month earlier. The autopsy was performed two days after death. The body was stored at 15°C. Gross autopsy findings revealed advanced putrefactive changes and an enlarged heart, with visible fibrotic focuses. The histopathological finding corresponded to the sudden cardiovascular death due to the cardiac dysrhythmia most probably formed in one of the fibrotic focuses. Tests for SARS-CoV-2 RNA and antibodies (IgM, IgG) were positive in the analyzed samples. Conclusion This report suggests that SARS-CoV-2 virus can be isolated in the biological samples even after a long post-mortem prolongation of molecular analyses. We emphasize the necessity of wider studies that will define the infectiveness and biological stability of the virus in postmortem tissues. © 2023, Serbia Medical Society. All rights reserved.
RESUMEN
This study was endeavored to contribute in furthering our understanding of the molecular epidemiology of SARS-CoV-2 by sequencing and analyzing the first full-length genome sequences obtained from 48 COVID-19 patients in five districts in Western Serbia in the period April 2020-July 2020. SARS-CoV-2 sequences in Western Serbia distinguished from the Wuhan sequence in 128 SNPs in total. Phylogenetic structure of local SARS-CoV-2 isolates suggested existence of at least four distinct groups of SARS-CoV-2 strains in Western Serbia. The first group is the most similar to the strain from Italy. These isolates included two 20A sequences and fifteen to thirty 20B sequences that displayed a newly occurring set of four conjoined mutations. The second group is the most similar to the strain from France, carrying two mutations and belonged to 20A clade. The third group is the most similar to the strain from Switzerland carrying four co-occurring mutations and belonging to 20B clade. The fourth group is the most similar to another strain from France, displaying one mutation that gave rise to a single local isolate that belonged to 20A clade. © 2021 Cambridge University Press. All rights reserved.