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分析 SARS-CoV-2 病毒在尸体中的存活时间,以及对尸检工作人员造成传染的风险。

Analysis of the persistence time of the SARS-CoV-2 virus in the cadaver and the risk of passing infection to autopsy staff.

机构信息

Institute of Legal Medicine, Department of Surgical and Medical Sciences, University "Magna Graecia" of Catanzaro, Italy.

Intensive Care Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy.

出版信息

Med Leg J. 2021 Mar;89(1):40-53. doi: 10.1177/0025817220980601. Epub 2021 Jan 21.

Abstract

The activity of the SARS-CoV-2 virus has not yet been studied in a post-mortem setting. The absence of these data has led to the prohibition of exposure of infected corpses during burial procedures. Our aim was to assess the virus's persistence and the possibility of transmission in the post-mortem phase including autopsy staff. The sample group included 29 patients who were admitted to our Covid-19 Centre who died during hospitalisation and the autopsy staff. All the swabs were subjected to a one-step real-time reverse transcription polymerase chain reaction with cycle threshold (Ct) values. Swab collection was performed at 2 h, 4 h, 6 h, 12 h, over 24 since death. The following were the analysis of patients' swabs: 10 cases were positive 2 h after death; 10 cases positive 4 h after death; 9 cases were found positive 6 h after death; 7 cases positive 12 h after death; 9 cases remained positive 24 h after death. The swabs performed on all the forensic pathologist staff on duty who performed the autopsies were negative. The choice to avoid rituals and the display of corpses before and at the burial procedures given appears cautiously valid due to the persistence of the SARS-CoV-2 virus in the post-mortem period. Although the caution in choosing whether or not to perform an autopsy on infected corpses is acceptable, not to perform autopsies is not biologically supported.

摘要

新冠病毒(SARS-CoV-2)在死后环境中的活性尚未得到研究。由于缺乏这些数据,导致在埋葬过程中禁止接触受感染的尸体。我们的目的是评估病毒在死后阶段(包括尸检人员)的持续存在和传播的可能性。样本组包括 29 名在我们的新冠病毒中心住院期间死亡的患者和尸检人员。所有拭子均采用一步实时逆转录聚合酶链反应(RT-PCR)进行检测,并记录循环阈值(Ct)值。在死亡后 2 小时、4 小时、6 小时、12 小时和 24 小时进行拭子采集。对患者拭子进行分析:10 例患者在死亡后 2 小时呈阳性;10 例患者在死亡后 4 小时呈阳性;9 例患者在死亡后 6 小时呈阳性;7 例患者在死亡后 12 小时呈阳性;9 例患者在死亡后 24 小时仍呈阳性。对所有在值班时进行尸检的法医病理学家进行拭子检测,结果均为阴性。由于 SARS-CoV-2 病毒在死后阶段的持续存在,避免在葬礼仪式前和葬礼期间展示尸体的选择似乎是谨慎有效的。虽然对于是否对感染尸体进行尸检的谨慎选择是可以接受的,但不进行尸检在生物学上是没有依据的。

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