Post-mortem viral dynamics and tropism in COVID-19 patients in correlation with organ damage.

Content Provider	Europe PMC
Author	Skok, Kristijan Stelzl, Evelyn Trauner, Michael Kessler, Harald H. Lax, Sigurd F.
Abstract	The persistence of SARS-CoV-2 after death of infected individuals is unclear. The aim of this study was to investigate the presence of SARS-CoV-2 RNA in different organs in correlation with tissue damage and post-mortem viral dynamics in COVID-19 deceased. Twenty-eight patients (17 males, 11 females; age 66–96 years; mean 82.9, median 82.5 years) diagnosed with COVID-19 were studied. Swabs were taken post-mortem during autopsy (N = 19) from the throat, both lungs, intestine, gallbladder, and brain or without autopsy (N = 9) only from the throat. Selective amplification of target nucleic acid from the samples was achieved by using primers for ORF1a/b non-structural region and the structural protein envelope E-gene of the virus. The results of 125 post-mortem and 47 ante-mortem swabs were presented as cycle threshold (Ct) values and categorized as strong, moderate, and weak. Viral RNA was detected more frequently in the lungs and throat than in the intestine. Blood, bile, and the brain were negative. Consecutive throat swabs were positive up to 128 h after death without significant increase of Ct values. All lungs showed diffuse alveolar damage, thrombosis, and infarction and less frequently bronchopneumonia irrespective of Ct values. In 30% the intestine revealed focal ischemic changes. Nucleocapsid protein of SARS-CoV-2 was detected by immunohistochemistry in bronchial and intestinal epithelium, bronchial glands, and pneumocytes. In conclusion, viral RNA is still present several days after death, most frequently in the respiratory tract and associated with severe and fatal organ damage. Potential infectivity cannot be ruled out post-mortem.Electronic supplementary materialThe online version of this article (10.1007/s00428-020-02903-8) contains supplementary material, which is available to authorized users.
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ISSN	09456317
Journal	Virchows Archiv [Virchows Arch]
Volume Number	478
DOI	10.1007/s00428-020-02903-8
PubMed Central reference number	PMC7438212
Issue Number	2
PubMed reference number	32815036
e-ISSN	14322307
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2020-08-20
Publisher Place	Berlin/Heidelberg
Access Restriction	Open
Rights License	Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2020
Subject Keyword	COVID-19 SARS-CoV-2 Post-mortem PCR Immunohistochemistry bowel
Content Type	Text
Resource Type	Article
Subject	Cell Biology Molecular Biology Pathology and Forensic Medicine