Positive RT-PCR for COVID-19 in the Exhumed Body: A Dilemma in Dead Body Safety, Virus Survival, and Genome Stability
Manjula S. *
Department of Oral and Maxillo-Facial Surgery, JSS Dental College and Hospital, JSSAHER, Mysore, Karnataka, India.
Somanna Ajjamada
Department of Genetics and Genomics, Manasa Gangothri, University of Mysore, Mysore, Karnataka, India.
T. S. Kiran
Department of Microbiology, Sridevi Institute of Medical Sciences and Research Hospital, Tumkuru, Karnataka, India.
D. R. Mahadeshwara Prasad
Department of Forensic Medicine & Toxicology, District Hospital and Designated COVID-19 Hospital, Mysore, Karnataka, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Most cases of COVID-19 could test positive for RT-PCR, weeks later, a possibility of an overestimation during the pandemic. RT-PCR results per se make it difficult to take proper decisions in the admission, treatment, and isolation of the cases. The constantly emerging new data about COVID-19 will dictate the strategies on quarantine, home isolation, hospitalization, and treatment protocol. The present study describes the finding that RT-PCR was positive for the COVID-19 virus genome among the swabs and the visceral samples processed after a total of 38 days.
Methods: A medico-legal exhumation was conducted, and the samples were analyzed for the coronavirus genome through RT-PCR.
Results: The RT-PCR test was positive for the presence of COVID-19 genome with a Cycle threshold (Ct) value of ≤ 35 which was used as a reference to declaring the test positive.
Discussion: The RNA viruses with a complex genomic structure have a wide host range and are exposed to various immune and ecological systems. Multiplicity Reactivation (MR) of the virus is not uncommon. It is quite difficult to infer the safety and herd immunity in the case of COVID-19 due to the concept of MR, a genome repair process. However, in the present study the RT-PCR test being positive needs explanation and draws the attention of the researchers concerning re-infection, genomic stability, immunogenetics, false positives, isolation and management, safe disposal of the deceased body, and bio-medical waste.
Keywords: Dead body safety, genome stability, COVID-19, positive RT-PCR, Multiplicity Reactivation