Original ArticlesComprehensive Severe Acute Respiratory Syndrome Coronavirus 2 Detection Using Polymerase Chain Reaction and Rapid Antigen Testing in Postmortem SpecimensMatsumoto, Sari MD, PhD∗; Takasu, Shojiro MD, PhD∗; Shimmura, Suzuka MD∗; Sakai, Ami MMS∗; Kanto, Yuko PhD∗; Kanuka, Hirotaka PhD†; Iwadate, Kimiharu MD, PhD∗ Author Information From the Departments of ∗Forensic Medicine †Tropical Medicine, The Jikei University School of Medicine, Tokyo, Japan. Manuscript received October 27, 2021; accepted December 4, 2021. The authors report no conflict of interest. This work was supported by the Ministry of Health, Labour and Welfare, KAKENHI (grant number 20ca2075). Reprints: Sari Matsumoto, MD, PhD, Department of Forensic Medicine, The Jikei University School of Medicine, Nishishinbashi 3-25-8, Minato-ku, Tokyo 105-8461, Japan. E-mail: [email protected]. The American Journal of Forensic Medicine and Pathology: June 2022 - Volume 43 - Issue 2 - p 105-109 doi: 10.1097/PAF.0000000000000748 Buy Metrics Abstract Polymerase chain reaction (PCR) is indispensable for diagnosing coronavirus disease 2019 (COVID-19) in autopsy cases. In this study, we performed comprehensive reverse transcription quantitative PCR (RT-qPCR) and rapid antigen tests for COVID-19 on forensic postmortem specimens, regardless of the antemortem symptoms and causes of death. Immediately before forensic external examination and autopsy, a wiping solution was collected from the nasopharynx with a dry swab, and rapid antigen testing and RT-qPCR were performed. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected by RT-qPCR in 12 of the 487 cases; the infection rate was 2.46%. Of the RT-qPCR–positive cases, 7 were associated with COVID-19–related deaths. Cycle threshold values were not correlated with the cause of death or postmortem time. The sensitivity and specificity of the rapid antigen test were 91.67% and 100.00%, respectively. The RT-qPCR positivity rate of forensic cases was higher than the cumulative infection rate for the entire population. SARS-CoV-2 could be detected with the rapid antigen test and RT-qPCR within 216 hours of death. Because the rapid antigen test showed the same sensitivity and specificity as those observed in clinical practice, the test combined with RT-qPCR may be useful for diagnosing COVID-19 even in postmortem specimens. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.