Substantial decrease in SARS-CoV-2 RNA after fixation of cadavers intended for anatomical dissection

Anat Sci Int. 2023 Jul;98(3):441-447. doi: 10.1007/s12565-023-00707-9. Epub 2023 Mar 4.

Abstract

With the onset of the COVID-19 pandemic, a problem arose with classic body donation programmes for obtaining cadavers for anatomical dissections, science and research. The question has emerged whether bodies of individuals who died of COVID-19 or were infected by SARS-CoV-2 could be admitted to Departments of Anatomy. To determine the risk of SARS-CoV-2 transmission to employees or students, the presence and stability of SARS-CoV-2 RNA in cadavers after fixation agents' application and subsequent post-fixation baths over time were examined. The presence of viral RNA in swabs from selected tissues was assessed by the standardized routine RNA isolation protocol and subsequent real-time PCR analysis. To support the results obtained from the tissue swabs, samples of RNA were exposed in vitro to short and long-term exposure to the components of the injection and fixation solutions used for the bodies' conservation. Substantial removal of SARS-CoV-2 RNA was observed in post-mortem tissue following perfusion with 3.5% phenol, 2.2% formaldehyde, 11.8% glycerol and 55% ethanol, and subsequent post-fixation in an ethanol bath. In vitro experiments showed significant effects of formaldehyde on SARS-CoV-2 RNA, while phenol and ethanol showed only negligible effects. We conclude that cadavers subjected to fixation protocols as described here should not pose a considerable risk of SARS-CoV-2 infection while being handled by students and staff and are, therefore, suitable for routine anatomical dissections and teaching.

Keywords: Coronavirus; Dissection; Embalming; Infections; Polymerase chain reaction.

MeSH terms

  • COVID-19*
  • Cadaver
  • Ethanol
  • Formaldehyde
  • Humans
  • Pandemics
  • Phenols
  • RNA, Viral
  • SARS-CoV-2*

Substances

  • RNA, Viral
  • Formaldehyde
  • Ethanol
  • Phenols