Nikhil Prasad Fact checked by:Thailand Medical News Team Jan 28, 2025 1 day, 16 hours, 36 minutes ago
Medical News: The SARS-CoV-2 virus, responsible for the COVID-19 pandemic, has profoundly impacted global healthcare, sparking extensive studies into its transmission methods. Among these, the post-mortem infectivity of SARS-CoV-2 in cadaveric tissues remains a lesser-explored but critical topic, carrying implications for both public health safety and forensic practices. A recent systematic review led by researchers from Magna Graecia University in Catanzaro, Italy, sheds light on this underexamined area.
Persistence of SARS-CoV-2 in Cadaveric Tissues and Transmission Risk
This
Medical News report delves into the persistence of the virus in various tissues after death and examines the risks posed during the handling of deceased individuals. The review's findings emphasize the need for robust protocols to protect forensic workers and inform public health guidelines.
Persistence of SARS-CoV-2 in Cadaveric Tissues
SARS-CoV-2’s resilience has been well-documented during life, but its persistence post-mortem presents unique challenges. Researchers investigated data from studies worldwide to understand how the virus behaves in different tissues after death. Factors such as the post-mortem interval, environmental conditions, and underlying health conditions of the deceased significantly influence the virus's infectivity.
The review highlighted that SARS-CoV-2 RNA and structural proteins are most commonly detected in the respiratory system, particularly the lungs and pharynx. These findings align with the virus’s primary infection sites during life. Notably, RNA fragments were found to persist for weeks after death, with some studies detecting viable virus particles up to 40 days post-mortem in specific tissues such as the lungs and trachea.
Viable virus presence does not necessarily indicate a high transmission risk, but it underscores the importance of careful handling during autopsies and other post-mortem examinations.
Methodology and Data Analysis
The review adhered to PRISMA guidelines, analyzing studies from PubMed and Scopus. Researchers examined publications using keywords like "COVID-19," "cadavers," and "persistence." After stringent quality control, 10 studies met the inclusion criteria. The Joanna Briggs Institute critical appraisal tools were utilized to ensure robust analysis.
Key findings included the persistence of viral RNA in lung tissues, nasopharyngeal swabs, and other organs. For example, in a study from Italy, nasopharyngeal swabs remained positive up to 35 days post-mortem. Another investigation in Japan revealed that viral RNA levels did not decline significantly even after 12 days in various tissues, including the lungs and spleen.
Safety Concerns for Forensic and Healthcare Workers
The persistence of SARS-CoV-2 in cadavers raises significant safety concerns for forensic investigators, healthcare workers, and mortuary staff.
Handling of infected bodies during autopsies or embalming involves direct exposure to potentially infectious tissues and fluids. Proper use of personal protective equipment (PPE) and adherence to safety protocols are paramount to minimizing these risks.
The study also found that embalming reduces viral RNA detectability, although it does not completely eliminate the presence of viable particles in some cases. Refrigeration, on the other hand, can prolong RNA stability, emphasizing the need for meticulous handling of bodies in morgues and forensic labs.
Comparing SARS-CoV-2 with Other Coronaviruses
The behavior of SARS-CoV-2 in cadaveric tissues differs from earlier coronaviruses like SARS-CoV and MERS-CoV. During their respective outbreaks, limited evidence existed about their post-mortem transmission. In contrast, SARS-CoV-2 demonstrates greater stability and persistence, likely due to its unique structural adaptations, such as its highly efficient spike protein. These features allow it to bind more effectively to ACE2 receptors and remain stable in various environmental conditions.
Practical Implications and Future Research
The findings underscore the need for stringent biosafety measures when handling COVID-19-positive cadavers. Autopsy procedures should incorporate enhanced precautions, including comprehensive disinfection protocols and training for forensic personnel. Moreover, public health guidelines should consider the persistence of the virus in deceased individuals when developing protocols for body transportation and disposal.
Future research should prioritize studying SARS-CoV-2 variants to assess their impact on post-mortem infectivity. Variants like Delta and Omicron, which exhibit increased transmissibility and tissue tropism, may behave differently in cadaveric tissues. Understanding these dynamics is crucial for refining safety protocols and mitigating risks.
Conclusions
The study by Magna Graecia University researchers highlights critical gaps in our understanding of SARS-CoV-2’s post-mortem infectivity. While viral RNA and proteins persist in cadavers, the actual risk of transmission remains low under proper safety measures. However, the potential for environmental contamination and occupational hazards cannot be ignored.
Developing evidence-based guidelines for handling infected cadavers is essential to protect forensic and healthcare workers. Embalming and refrigeration practices, combined with strict PPE usage, can significantly reduce risks. Future studies must address the behavior of emerging variants and explore long-term environmental implications of post-mortem viral persistence.
The study findings were published in the peer-reviewed journal: Microorganisms.
https://www.mdpi.com/2076-2607/13/2/284
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https://www.thailandmedical.news/articles/coronavirus
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