Ferenčić, Antun; Stemberger, Christophe2; Cuculić, Dražen; Jakovac, Hrvoje1,
Department of Forensic Medicine and Criminalistics, University of Rijeka, Faculty of Medicine, Rijeka, Croatia
1Department of Physiology and Immunology, University of Rijeka, Faculty of Medicine, Rijeka, Croatia
2Department of Pathology, Clinical Hospital Centre Rijeka, Rijeka, Croatia
Address for correspondence: Dr. Hrvoje Jakovac, Department of Physiology and Immunology, University of Rijeka, Faculty of Medicine, Braće Branchetta 20, 51000 Rijeka, Croatia. E-mail: [email protected]
Received April 26, 2021
Accepted August 30, 2021
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Dear Editor,
During the recent COVID-19 pandemic and rapid spreading of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), performing routine autopsies has posed a serious concern regarding viral transmission.[1,2] Several well-designed and convincing studies showed high postmortem stability of the SARS-CoV-2 virus in previously symptomatic patients,[3,4] pointing that bodies of persons deceased from the COVID-19 may be a source of infection. Unusual and unpredictable behavior of the virus, along with uncertainties concerning the viral lifespan outside the living host under different external conditions, brings serious difficulties to great efforts in curbing the infection spread. Therefore, specific safety measures were implemented during the autopsy of deceased COVID-19 patients.[1,2] Apart from that, avoiding autopsies was recommended if it not strictly necessary or legally prescribed for forensic cases.[1] To further emphasize the importance of rigorous and unceasing caution with regard to the possibility of unexpected SARS-CoV-2 positivity during forensic investigations, here we report postmortem detection of SARS-CoV-2 in the nasopharyngeal swabs obtained from two severely burned and carbonized bodies of persons who died in the car fire accident. After receiving the decedents to forensic medical examination, severe combustions and carbonization reaching the muscles were found on both bodies. The estimated time of direct flame exposure was 5 min. Nevertheless, no macroscopic signs of mucosal burns or soot traces were detected in the larynx, and carboxyhemoglobin proportions were 8.2% and 3.1%, indicating there had been no greater smoke inhalation. Upon receipt of information that a hospitalized survivor of an accident from the same car had been found SARS-CoV-2 positive, nasopharyngeal swabs were taken from the carbonized bodies on the 60th hour after death. Viral RNA test was performed by GeneFinder COVID-19 plus RealAmp kit, and all three viral genes analyzed were detected in both samples at relatively low cycle thresholds (Ct): CoV RdRp (Ct = 21.22 and 30.14), CoV E (Ct = 20.81 and 34.55), and CoV N (Ct = 21.78 and 34.64). The detailed forensic investigation concluded that the persons were asymptomatic before the accident. Such peculiar findings underline considerable postmortem SARS-CoV-2 stability, even from asymptomatic persons with unrecognized infection, and who were exposed to extreme temperatures after death. As exposure to high temperatures is widely considered as one of the most effective viral degrading factors,[5] similar scenarios could lead to the misconclusion that infection possibility is completely precluded during the autopsy and handling with obtained material in such circumstances.
Ethics approval
The authors declare that the study has been done according to the ethical standards, ethics approval and consent.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
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2. Basso C, Calabrese F, Sbaraglia M, Del Vecchio C, Carretta G, Saieva A, et al Feasibility of postmortem examination in the era of COVID-19 pandemic: The experience of a Northeast Italy University Hospital Virchows Arch. 2020;477:341–7
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4. Heinrich F, Meißner K, Langenwalder F, Püschel K, Nörz D, Hoffmann A, et al Postmortem stability of SARS-CoV-2 in nasopharyngeal mucosa Emerg Infect Dis. 2021;27:329–31
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