Post-mortem viral dynamics and tropism in COVID-19 patients in correlation with organ damage
- PDF / 3,011,084 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 34 Downloads / 128 Views
ORIGINAL ARTICLE
Post-mortem viral dynamics and tropism in COVID-19 patients in correlation with organ damage Kristijan Skok 1 & Evelyn Stelzl 2 & Michael Trauner 3 & Harald H. Kessler 2 & Sigurd F. Lax 1,4 Received: 19 June 2020 / Revised: 22 July 2020 / Accepted: 6 August 2020 # The Author(s) 2020
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 COVID19 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. Keywords COVID-19 . SARS-CoV-2 . Post-mortem . PCR . Immunohistochemistry bowel
Introduction This article is part of the Topical Collection on Quality in Pathology Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00428-020-02903-8) contains supplementary material, which is available to authorized users. * Sigurd F. Lax [email protected] 1
Department of Pathology, Hospital Graz II, Academic Teaching Hospital of the Medical University of Graz, Goestingerstrasse 22, AT-8020 Graz, Austria
2
Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstrasse 6, AT-8010 Graz, Austria
3
Division of Gastroenterology and Hepatology with Intensive Care 13H1, Department of Internal Medicine III, Vienna General Hospital, Medical University of Vienna, Waehringerguertel 18-20, AT-1090 Vienna, Austria
4
School of Medicine, Clinical Institute of Pathology and Molecular Pathology, Johannes Kepler University Linz, Huemerstrasse 3-5, AT-4020 Linz, Austria
The coronavir
Data Loading...
