ABSTRACT
Background &
objectives:
High transmissibility of the
SARS-CoV-2 has significant implications on
healthcare workers’
safety, preservation, handling,
transportation and disposal of the deceased bodies. The objective of this study was to detect
SARS-CoV-2 antigen in nasopharyngeal samples and its implications in handling and care of COVID-19 deceased bodies.
Methods:
A study was conducted at a dedicated COVID-19 centre on deceased individuals from April to December 2020. Rapid
antigen test (
RAT) and
reverse transcription (RT)-
PCR was compared on all the
SARS-CoV-2 positive
cadavers recruited in the study.
Results:
A total of 115 deceased individuals were included in the study. Of these, 79 (68.7%) were
male and 36 (31.3%) were
female and majority were in the
age group of 51-60 yr [31 (27%)].
SARS-CoV-2 antigen test was positive in 32 (27.8%) and negative in 83 (72.1%) individuals. The mean
time interval between deaths to the sample collection was 13.2 h with interquartile range of eight to 20 h.
Reverse transcription (RT)-
PCR was used as the reference test and 24 (20.9%) cases were true positive; 93.6 per cent [95%
confidence interval (CI) 88.8-98.4%]
sensitivity, 45.2 per cent (95% CI 35.5-55%)
specificity, 60.2 per cent (95% CI 50.6-69.8%)
positive predictive value and 88.8 per cent (95% CI 82.7-95%)
negative predictive value of
antigen test was computed. Interpretation &
conclusions:
SARS-CoV-2 antigen test was positive beyond 19 h in COVID-19 deceased individuals.
Antigen test was found to be highly sensitive in the deceased.
Patients, suspected of having died due to COVID-19, can be screened by this
method. As infectiousness of the
virus in the deceased bodies cannot be directly concluded from either the
antigen or RT-PCR test, yet possible
transmission cannot be completely ruled out. Strict
infection control measures need to be followed during the handling and clearance of COVID-19
cadavers.