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This attitude has changed, and autopsies are now recognized as indispensable tools for understanding COVID-19, but the true risk of infection to autopsy staff is nevertheless still debated. To clarify the rate of SARS-CoV-2 contamination in personal protective equipment (PPE), swabs were taken at nine points in the PPE of one physician and one assistant after each of 11 full autopsies performed at four centers. Swabs were also obtained from three minimally invasive autopsies (MIAs) conducted at a fifth center. Lung\/bronchus swabs of the deceased served as positive controls, and SARS-CoV-2 RNA was detected by real-time RT-PCR. In 9 of 11 full autopsies, PPE samples tested RNA positive through PCR, accounting for 41 of the 198 PPE samples taken (21%). The main contaminated items of the PPE were gloves (64% positive), aprons (50% positive), and the tops of shoes (36% positive) while the fronts of safety goggles, for example, were positive in only 4.5% of the samples, and all the face masks were negative. In MIAs, viral RNA was observed in one sample from a glove but not in other swabs. Infectious virus isolation in cell culture was performed on RNA-positive swabs from the full autopsies. Of all the RNA-positive PPE samples, 21% of the glove samples, taken in 3 of 11 full autopsies, tested positive for infectious virus. In conclusion, PPE was contaminated with viral RNA in 82% of autopsies. In 27% of autopsies, PPE was found to be contaminated even with infectious virus, representing a potential risk of infection to autopsy staff. Adequate PPE and hygiene measures, including appropriate waste deposition, are therefore essential to ensure a safe work environment.<\/jats:p>","DOI":"10.1007\/s00428-021-03263-7","type":"journal-article","created":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T16:11:51Z","timestamp":1641485511000},"page":"519-528","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Contamination of personal protective equipment during COVID-19 autopsies"],"prefix":"10.1007","volume":"480","author":[{"given":"Johanna M.","family":"Brandner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Boor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Borcherding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin","family":"Edler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Gerber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Heinemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Hilsenbeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuko","family":"Kasajima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa","family":"Lohner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7704-850X","authenticated-orcid":false,"given":"Bruno","family":"M\u00e4rkl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Pablik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann Sophie","family":"Schr\u00f6der","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Slotta-Huspenina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linna","family":"Sommer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Peter","family":"Sperhake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia","family":"von Stillfried","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Dintner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,6]]},"reference":[{"key":"3263_CR1","doi-asserted-by":"publisher","first-page":"3704","DOI":"10.1128\/aem.60.10.3704-3710.1994","volume":"60","author":"FX Abad","year":"1994","unstructured":"Abad FX, Pinto RM, Bosch A (1994) Survival of enteric viruses on environmental fomites. Appl Environ Microbiol 60:3704\u20133710. https:\/\/doi.org\/10.1128\/aem.60.10.3704-3710.1994","journal-title":"Appl Environ Microbiol"},{"key":"3263_CR2","doi-asserted-by":"publisher","unstructured":"Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, Vanstapel A, Werlein C, Stark H, Tzankov A, Li WW, Li VW, Mentzer SJ, Jonigk D (2020) Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19 N Engl J Med 383:120\u2013128. https:\/\/doi.org\/10.1056\/NEJMoa2015432","DOI":"10.1056\/NEJMoa2015432"},{"key":"3263_CR3","doi-asserted-by":"publisher","unstructured":"Aquila I, Ricci P, Bonetta CF, Sacco MA, Longhini F, Torti C, Mazzitelli M, Garofalo E, Bruni A, Trecarichi EM, Serapide F, Gratteri S, Quirino A, Barreca GS, Abenavoli L, Arena V, Oliva A, Giancotti A, Iavicoli I, Liberto MC, Matera G (2021) Analysis of the persistence time of the SARS-CoV-2 virus in the cadaver and the risk of passing infection to autopsy staff Med Leg J:25817220980601. https:\/\/doi.org\/10.1177\/0025817220980601","DOI":"10.1177\/0025817220980601"},{"key":"3263_CR4","doi-asserted-by":"publisher","unstructured":"Basso C, Calabrese F, Sbaraglia M, Del Vecchio C, Carretta G, Saieva A, Donato D, Flor L, Crisanti A, Dei Tos AP (2020) Feasibility of postmortem examination in the era of COVID-19 pandemic: the experience of a Northeast Italy University Hospital Virchows Arch 477:341\u2013347. https:\/\/doi.org\/10.1007\/s00428-020-02861-1","DOI":"10.1007\/s00428-020-02861-1"},{"key":"3263_CR5","doi-asserted-by":"publisher","unstructured":"B\u00f6sm\u00fcller H, Traxler S, Bitzer M, Haberle H, Raiser W, Nann D, Frauenfeld L, Vogelsberg A, Klingel K, Fend F (2020) The evolution of pulmonary pathology in fatal COVID-19 disease: an autopsy study with clinical correlation Virchows Arch 477:349\u2013357. https:\/\/doi.org\/10.1007\/s00428-020-02881-x","DOI":"10.1007\/s00428-020-02881-x"},{"key":"3263_CR6","doi-asserted-by":"publisher","unstructured":"Brehm TT, Pfefferle S, von Possel R, Kobbe R, Norz D, Schmiedel S, Grundhoff A, Olearo F, Emmerich P, Robitaille A, Gunther T, Braun P, Andersen G, Knobloch JK, Addo MM, Lohse AW, Aepfelbacher M, Fischer N, Schulze Zur Wiesch J, Lutgehetmann M (2021) SARS-CoV-2 reinfection in a healthcare worker despite the presence of detectable neutralizing antibodies viruses 13. https:\/\/doi.org\/10.3390\/v13040661","DOI":"10.3390\/v13040661"},{"key":"3263_CR7","doi-asserted-by":"publisher","unstructured":"Davis GG, Williamson AK (2020) Risk of COVID-19 transmission during autopsy Arch Pathol Lab Med. https:\/\/doi.org\/10.5858\/arpa.2020-0345-LE","DOI":"10.5858\/arpa.2020-0345-LE"},{"key":"3263_CR8","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1007\/s00414-020-02317-w","volume":"134","author":"C Edler","year":"2020","unstructured":"Edler C, Schr\u00f6der AS, Aepfelbacher M, Fitzek A, Heinemann A, Heinrich F, Klein A, Langenwalder F, Lutgehetmann M, Meissner K, P\u00fcschel K, Schadler J, Steurer S, Mushumba H, Sperhake JP (2020) Dying with SARS-CoV-2 infection-an autopsy study of the first consecutive 80 cases in Hamburg Germany. 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Written consent to perform the autopsies was obtained from the next of kin.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}