Rate of shed of SARS COV-2 viral RNA from COVID-19 cadavers

Meenakshi Sharma; Megha Brijwal; Nabarun Chakraborty; Aashish Choudhary; Arbind Kumar; Sharad Srivastav; Parin Lalwani; Richa Agrawal; Kapil Dev Soni; Nirupam Madaan; Rajesh Malhotra; Purva Mathur; Sanjeev Lalwani; Lalit Dar; Anjan Trikha

doi:10.1016/j.jiph.2022.11.001

Rate of shed of SARS COV-2 viral RNA from COVID-19 cadavers

J Infect Public Health. 2022 Dec;15(12):1486-1493. doi: 10.1016/j.jiph.2022.11.001. Epub 2022 Nov 4.

Authors

Meenakshi Sharma¹, Megha Brijwal², Nabarun Chakraborty³, Aashish Choudhary⁴, Arbind Kumar⁵, Sharad Srivastav⁶, Parin Lalwani⁷, Richa Agrawal⁸, Kapil Dev Soni⁹, Nirupam Madaan¹⁰, Rajesh Malhotra¹¹, Purva Mathur¹², Sanjeev Lalwani¹³, Lalit Dar¹⁴, Anjan Trikha¹⁵

Affiliations

¹ Division of Forensic Pathology and Molecular DNA, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Raj Nagar, New Delhi 110029, India. Electronic address: specialmeenakshi@gmail.com.
² Department of Microbiology, All India Institute of Medical Sciences, Raj Nagar, New Delhi 110029, India. Electronic address: megha.brijwal@yahoo.com.
³ Division of Forensic Pathology and Molecular DNA, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Raj Nagar, New Delhi 110029, India. Electronic address: nabarun9816@gmail.com.
⁴ Department of Microbiology, All India Institute of Medical Sciences, Raj Nagar, New Delhi 110029, India. Electronic address: aashishpath@yahoo.co.in.
⁵ Department of Microbiology, All India Institute of Medical Sciences, Raj Nagar, New Delhi 110029, India. Electronic address: arbind702@gmail.com.
⁶ Department of Microbiology (Laboratory Medicine), Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Raj Nagar, New Delhi 110029, India. Electronic address: shrd2855@gmail.com.
⁷ Department of Anaesthesia and Critical Care, All India Institute of Medical Sciences, New Delhi 110029, India. Electronic address: drparinlalwani@gmail.com.
⁸ Department of Anaesthesia and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Raj Nagar, New Delhi 110029, India. Electronic address: pathakricha@yahoo.co.in.
⁹ Department of Anaesthesia and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Raj Nagar, New Delhi 110029, India. Electronic address: kdsoni111@gmail.com.
¹⁰ Department of Hospital Administration, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Raj Nagar, New Delhi 110029, India. Electronic address: office.nirupam@gmail.com.
¹¹ Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Raj Nagar, New Delhi 110029, India. Electronic address: rmalhotra62@gmail.com.
¹² Department of Microbiology (Laboratory Medicine), Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Room No. 325, Raj Nagar, New Delhi 110029, India. Electronic address: purvamathur@yahoo.co.in.
¹³ Division of Forensic Pathology and Molecular DNA, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Raj Nagar, Room No. 116, New Delhi 110029, India. Electronic address: drsanjeevlalwani@gmail.com.
¹⁴ Department of Microbiology, All India Institute of Medical Sciences, Raj Nagar, New Delhi 110029, India. Electronic address: lalitdaraiims@gmail.com.
¹⁵ Department of Anaesthesia and Critical Care, All India Institute of Medical Sciences, New Delhi 110029, India. Electronic address: anjantrikha@gmail.com.

Abstract

Background: At what rate does the RNA of SARS CoV-2 shed from cadavers? Although, there have been numerous studies which have demonstrated the persistence of the virus on dead bodies, there is a lack of conclusive evidence regarding the variation of viral RNA content in cadavers. This has led to a knowledge gap regarding the safe handling/management of COVID-19 decedents, posing a barrier in forensic investigations.

Methods: In this study, we report the presence of RNA of SARS CoV-2 by real time RT-PCR, in nasopharyngeal swabs collected after death from two groups of bodies - one who died due to COVID-19 and the other who died due to other diagnoses. A prospective study on 199 corpses, who had tested positive for COVID-19 ante-mortem, was conducted at a tertiary care center. RNA testing was conducted at different time intervals (T1-T5).

Results: 112(56.3%) died primarily due to COVID-19 and 87(43.7%) died due to other diagnoses. 144(72.4%) were male and 55(27.6%) were female. A total of 115 (57.8%) tested positive for COVID-19 after death at different time points. The mean age was 50.7 ± 18.9 years and the length of hospitalization ranged from 1 to 50 days with a mean of 9.2 ± 7.6 days. Realtime RT-PCR positivity of SARS CoV-2 RNA decreases with time.

Conclusion: We observed that real time RT-PCR positivity, indicating viral RNA detection, decreases with time. Therefore, it is advisable to follow appropriate COVID-19 precautions to carry out scientific studies, medico-legal investigations and mortuary services on suspected/confirmed COVID-19 corpses.

Keywords: Autopsy; COVID-19; Public health; SARS-CoV-2; Viral persistence.

MeSH terms

COVID-19* / diagnosis
Cadaver
Female
Humans
Infant
Male
Prospective Studies
RNA, Viral
SARS-CoV-2

Substances

RNA, Viral