The novel SARS-CoV-2 virus can be lurking around in some parts of the body even after 18 hours of death. A clinical autopsy done on the dead body of a 62-year-old COVID-19 patient in Bengaluru, who died after 14 days of treatment, has revealed that the virus was active in the mouth, throat and nasal area 18 hours after his death.
The autopsy, claimed to be the first in India, was done early last week by forensic expert Dinesh Rao, who heads the Department of Forensic Medicine in Oxford Medical College and Research Institute in the city. “I took up the autopsy to understand the disease process and its outcome, and to study if there is a need to modify the treatment protocols. Of the various swabs I took, those from the mouth, throat and nose tested RT-PCR positive, while there was no trace of the virus on the skin of the face, neck, or internal organs like the respiratory passage and lungs. That is because the lung surface was dominated by bacterial infections,” Dr. Rao said.
Virus effect
“The lungs, which are normally like a soft sponge ball, were more like a leather ball. They normally weigh about 600-700 gm, but this victim’s lungs together weighed 2,180 gm and the texture was leathery. There were blood clots and the air sacs were ruptured. It was shocking to see what the virus had done to the lungs,” he said.
“These findings indicate that artificial ventilation or oxygen administration would not have helped the patient. The patient required thrombolytic therapies that involve dissolving the clots in the body first. The air sacs were filled with clots and that had to be dissolved first,” he explained.
Also, going by these findings it is advisable that all COVID-19 bodies should be cremated and not be handed over to families, he said.
Stating that these findings only pertain to a single COVID-19 body, the doctor said: “We need more research to understand the disease process and modify our treatment protocols instead of blindly following what the World Health Organisation (WHO) recommends. All guidelines and treatment protocols put out by the Indian Council of Medical Research (ICMR) are based on WHO recommendations and international data.
Dr. Rao, who conducted the 1.10-hour autopsy all alone as none were willing to join him, said he only took help to lift the body and keep it on the autopsy table. “There are a few more tests — immunohistochemistry, CT scan of the body, electron microscopic, and virological tests — that I wanted to do but had no facilities. More research is needed in this regard,” he added.
