Post-mortem COVID-19 Positive Testing: Institute of Forensic Sciences Experience

Abstract

Objective: The main objective was to present the experience of the Institute of Forensic Sciences of Puerto Rico in facing the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19. It has been found that some COVID-19 positive cases may continue to show post-mortem positive results for up to 49 days. Methods: The in vitro technique of ID NOW COVID-19 was used in the analysis to evaluate the presence of SARS-Cov-2 in postmortem forensic cases. This isothermal method allows to amplify and identify the presence of the RNA-dependent RNA polymerase viral segment. Information on demographics, comorbidities, and the manner and cause of death was collected. Results: A total of 612 subjects were sampled, of which 41 (6.7%) tested positive for COVID-19;14 (34.1%) of those subjects remained positive for more than 7 days Postmortem. Of the 41 positive cases, only 3 (7.3%) had been diagnosed with COVID-19 before their demise. The most common comorbidities were hypertension (36%), obesity (29%), and mental health conditions (50%). Conclusion: Results from postmortem COVID-19 testing revealed that some cadavers remain COVID-19 positive for a longer period than expected. Despite this, based on the information collected from the cases that were tested more than once, there is no direct correlation between the cause of death and persistent COVID-19 positivity. We recommend that additional investigations be carried out, in which investigations viral load and the maximum time of the infectious phase are specifically evaluated.