Persistence of SARS-CoV-2 Viral RNA in Nasopharyngeal Swabs after Death: An Observational Study

Francesca Servadei¹, Silvestro Mauriello², Manuel Scimeca^{1

3

4}, Bartolo Caggiano², Marco Ciotti⁵, Lucia Anemona¹, Manuela Montanaro¹, Erica Giacobbi¹, Michele Treglia², Sergio Bernardini⁵, Luigi Tonino Marsella², Nicoletta Urbano⁶, Orazio Schillaci³, Alessandro Mauriello^{1

7}

Affiliations

¹ Anatomic Pathology, Department of Experimental Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
² Forensic Medicine, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
³ Nuclear Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
⁴ Saint Camillus International University of Health Sciences, Via di Sant'Alessandro, 8, 00131 Rome, Italy.
⁵ Division of Clinical Biochemistry and Clinical Molecular Biology, Department of Experimental Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
⁶ Nuclear Medicine, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", 00133 Rome, Italy.
⁷ Tor Vergata Oncoscience Research (TOR), University of Rome "Tor Vergata", 00133 Rome, Italy.

PMID: 33920259
PMCID: PMC8103507
DOI: 10.3390/microorganisms9040800

Persistence of SARS-CoV-2 Viral RNA in Nasopharyngeal Swabs after Death: An Observational Study

Francesca Servadei et al. Microorganisms. 2021.

. 2021 Apr 10;9(4):800.

doi: 10.3390/microorganisms9040800.

Authors

Affiliations

¹ Anatomic Pathology, Department of Experimental Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
² Forensic Medicine, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
³ Nuclear Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
⁴ Saint Camillus International University of Health Sciences, Via di Sant'Alessandro, 8, 00131 Rome, Italy.
⁵ Division of Clinical Biochemistry and Clinical Molecular Biology, Department of Experimental Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
⁶ Nuclear Medicine, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", 00133 Rome, Italy.
⁷ Tor Vergata Oncoscience Research (TOR), University of Rome "Tor Vergata", 00133 Rome, Italy.

PMID: 33920259
PMCID: PMC8103507
DOI: 10.3390/microorganisms9040800

Abstract

The aim of this study was to investigate the persistence of SARS-CoV-2 in post-mortem swabs of subjects who died from SARS-CoV-2 infection. The presence of the virus was evaluated post-mortem from airways of 27 SARS-CoV-2 positive patients at three different time points (T1 2 h; T2 12 h; T3 24 h) by real-time PCR. Detection of antibodies to SARS-CoV-2 was performed by Maglumi 2019-nCoV IgM/IgG chemiluminescence assay. SARS-CoV-2 viral RNA was still detectable in 70.3% of cases within 2 h after death and in 66,6% of cases up to 24 h after death. Our data showed an increase of the viral load in 78,6% of positive individuals 24 h post-mortem (T3) in comparison to that evaluated 2 h after death (T1). Noteworthy, we detected a positive T3 post-mortem swab (24 h after death) from 4 subjects who were negative at T1 (2 h after death). The results of our study may have an important value in the management of deceased subjects not only with a suspected or confirmed diagnosis of SARS-CoV-2, but also for unspecified causes and in the absence of clinical documentation or medical assistance.

Keywords: SARS-CoV-2; autopsy; medico-legal procedures; pandemic.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Cited by

Long-Term Persisting SARS-CoV-2 RNA and Pathological Findings: Lessons Learnt From a Series of 35 COVID-19 Autopsies.
Maccio U, Zinkernagel AS, Schuepbach R, Probst-Mueller E, Frontzek K, Brugger SD, Hofmaenner DA, Moch H, Varga Z. Maccio U, et al. Front Med (Lausanne). 2022 Feb 9;9:778489. doi: 10.3389/fmed.2022.778489. eCollection 2022. Front Med (Lausanne). 2022. PMID: 35223894 Free PMC article.
SARS-CoV-2 antigen detection in deceased bodies: implications for infection prevention.
Sharma M, Kiro VV, Srivastav S, Mansoori N, Lalwani P, Lathwal A, Agrawal R, Soni KD, Madaan N, Malhotra R, Trikha A, Lalwani S, Mathur P. Sharma M, et al. Indian J Med Res. 2023 Jan;158(1):33-39. doi: 10.4103/ijmr.ijmr_2794_21. Indian J Med Res. 2023. PMID: 37602584 Free PMC article.
Diagnosing milk aspiration as a cause of death in sudden unexpected infant death: forensic insights from post-mortem analysis impacting criminal investigations.
Tavone AM, Servadei F, Cazzato F, Giacobbi E, Bonfiglio R, Oliva A, Marella GL. Tavone AM, et al. Forensic Sci Med Pathol. 2025 Jan 31. doi: 10.1007/s12024-025-00958-0. Online ahead of print. Forensic Sci Med Pathol. 2025. PMID: 39888577
SARS-CoV-2 (COVID-19) Experience at an Academic Medical Examiner's Office.
Prahlow JA, Jones P, Bailey K, Grande A, Obead A, Pink C, Douglas E, Shattuck B, Fisher-Hubbard A, Brown T, deJong JL. Prahlow JA, et al. Acad Forensic Pathol. 2024 May 30;14(3):87-107. doi: 10.1177/19253621231224532. eCollection 2024 Sep. Acad Forensic Pathol. 2024. PMID: 39246388 Free PMC article.
Spread of COVID-19 Infection in Long-Term Care Facilities of Trieste (Italy) during the Pre-Vaccination Era, Integrating Findings of 41 Forensic Autopsies with Geriatric Comorbidity Index as a Valid Option for the Assessment of Strength of Causation.
Zanon M, Peruch M, Concato M, Moreschi C, Pizzolitto S, Radaelli D, D'Errico S. Zanon M, et al. Vaccines (Basel). 2022 May 13;10(5):774. doi: 10.3390/vaccines10050774. Vaccines (Basel). 2022. PMID: 35632530 Free PMC article.

See all "Cited by" articles

References

1. Zhu N., Zhang D., Wang W., Li X., Yang B., Song J., Zhao X., Huang B., Shi W., Lu R., et al. A novel coronavirus from patients with pneumonia in China. N Engl. J. Med. 2020;382:727–733. doi: 10.1056/NEJMoa2001017. - DOI - PMC - PubMed
1. Cui J., Li F., Shi Z.L. Origin and evolution of pathogenic coronaviruses. Nat. Rev. Microbiol. 2019;17:181–192. doi: 10.1038/s41579-018-0118-9. - DOI - PMC - PubMed
1. Chen Y., Liu Q., Guo D. Emerging coronaviruses: Genome structure, replication, and pathogenesis. J. Med. Virol. 2020;92:418–423. doi: 10.1002/jmv.25681. - DOI - PMC - PubMed
1. Scimeca M., Urbano N., Bonfiglio R., Montanaro M., Bonanno E., Schillaci O., Mauriello A. Imaging Diagnostics and Pathology in SARS-CoV-2 Related Diseases. Int. J. Mol. Sci. 2020;21:6960. doi: 10.3390/ijms21186960. - DOI - PMC - PubMed
1. World Health Organization (WHO) Coronavirus disease (COVID-2019) situation reports. [(accessed on 13 December 2020)]; Available online: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio...

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Persistence of SARS-CoV-2 Viral RNA in Nasopharyngeal Swabs after Death: An Observational Study

Affiliations

Persistence of SARS-CoV-2 Viral RNA in Nasopharyngeal Swabs after Death: An Observational Study

Authors

Affiliations

Abstract

Conflict of interest statement

Similar articles

Cited by

References

LinkOut - more resources

Full Text Sources

Other Literature Sources

Miscellaneous