{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:40:41Z","timestamp":1790095241633,"version":"4.0.1"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T00:00:00Z","timestamp":1622592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T00:00:00Z","timestamp":1622592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Hamburg-Eppendorf (UKE)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Forensic Sci Med Pathol"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The body of a deceased  with Severe Acute Respiratory Syndrome Coronavirus 2\u00a0(SARS-CoV-2) infection is considered infectious. In this study, we present the results of infectivity testing of the body and testing of mortuary staff for SARS-CoV-2.\u00a0We performed real-time quantitative polymerase chain reaction (RT-qPCR) for SARS-CoV-2 on 33 decedents with ante mortem confirmed SARS-CoV-2 infection. Swabs of the body surface from five different body regions and from the body bag or coffin were examined. A subset of the swabs was brought into cell culture. In addition, screening of 25 Institute of Legal Medicine (ILM) personnel for ongoing or past SARS-CoV-2 infection was performed at two different time points during the pandemic. Swabs from all locations of the body surface and the body environment were negative in cases of negative post mortem nasopharyngeal testing (n=9). When the post mortem nasopharyngeal swab tested positive (n=24), between 0 and 5 of the body surface swabs were also positive, primarily the perioral region. In six of the cases, the body bag also yielded a positive result. The longest postmortem interval with positive SARS-CoV-2 RT-qPCR at the body surface was nine days. In no case viable SARS-CoV-2 was\u00a0found on the skin of the bodies or the body bags. One employee (autopsy technician) had possible occupational infection with SARS-CoV-2; all other employees were\u00a0tested negative for SARS-CoV-2 RNA or antibody twice. Our data indicate that with adequate management of general safety precautions, transmission of SARS-CoV-2 through autopsies and handling of bodies is unlikely.<\/jats:p>","DOI":"10.1007\/s12024-021-00379-9","type":"journal-article","created":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T14:23:30Z","timestamp":1622643810000},"page":"411-418","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["The handling of SARS-CoV-2 associated deaths\u00a0-\u00a0infectivity of the body"],"prefix":"10.1007","volume":"17","author":[{"given":"Ann Sophie","family":"Schr\u00f6der","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin","family":"Edler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Ondruschka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"P\u00fcschel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Sch\u00e4dler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Heinemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Heinrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"L\u00fctgehetmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Pfefferle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Aepfelbacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Fitzek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Peter","family":"Sperhake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,2]]},"reference":[{"key":"379_CR1","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1093\/ajcp\/aqaa062","volume":"153","author":"LM Barton","year":"2020","unstructured":"Barton LM, Duval EJ, Stroberg E, Ghosh S, Mukhopadhyay S. COVID-19 autopsies, Oklahoma, USA. Am J Clin Pathol. 2020;153:725\u201333.","journal-title":"Am J Clin Pathol"},{"key":"379_CR2","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/S0140-6736(20)31759-1","volume":"396","author":"F Braun","year":"2020","unstructured":"Braun F, L\u00fctgehetmann M, Pfefferle S, Wong MN, Carsten A, et al. SARS-CoV-2 renal tropism associates with acute kidney injury. Lancet. 2020;396:597\u20138.","journal-title":"Lancet"},{"key":"379_CR3","doi-asserted-by":"publisher","DOI":"10.3201\/eid2701.203112","author":"F Heinrich","year":"2020","unstructured":"Heinrich F, Mei\u00dfner K, Langenwalder F, P\u00fcschel K, N\u00f6rz D, et al. Postmortem stability of SARS-CoV-2 in nasopharyngeal mucosa. Emerg Infect Dis. 2020. https:\/\/doi.org\/10.3201\/eid2701.203112.","journal-title":"Emerg Infect Dis"},{"key":"379_CR4","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.3551","author":"D Lindner","year":"2020","unstructured":"Lindner D, Fitzek A, Br\u00e4uninger H, Aleshcheva G, Edler C, et al. Association of cardiac Infection with SARS-CoV-2 in confirmed COVID-19 autopsy cases. JAMA Cardiol. 2020. https:\/\/doi.org\/10.1001\/jamacardio.2020.3551.","journal-title":"JAMA Cardiol"},{"key":"379_CR5","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1056\/NEJMc2011400","volume":"383","author":"VG Puelles","year":"2020","unstructured":"Puelles VG, L\u00fctgehetmann M, Lindenmeyer MT, Sperhake JP, Wong MN, et al. Multiorgan and renal tropism of SARS-CoV-2. N Engl J Med. 2020;383:590\u20132.","journal-title":"N Engl J Med"},{"key":"379_CR6","doi-asserted-by":"crossref","unstructured":"Wichmann D, Sperhake J-P, L\u00fctgehetmann M, Steurer S, Edler C, et al. Autopsy findings and venous thromboembolism in patients with COVID-19. A prospective cohort study. Ann Intern Med. 2020;173:268\u201377.","DOI":"10.7326\/L20-1206"},{"key":"379_CR7","doi-asserted-by":"publisher","first-page":"1445a","DOI":"10.5858\/arpa.2020-0345-LE","volume":"144","author":"GG Davis","year":"2020","unstructured":"Davis GG, Williamson AK. Risk of COVID-19 transmission during autopsy. Arch Pathol Lab Med. 2020;144:1445a\u20131445.","journal-title":"Arch Pathol Lab Med"},{"key":"379_CR8","unstructured":"European Center for Disease Prevention and Control (ECDC). Considerations related to the safe handling of bodies of deceased persons with suspected or confirmed COVID-19. 2020. https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/COVID-19-safe-handling-of-bodies-or-persons-dying-from-COVID19.pdf."},{"key":"379_CR9","doi-asserted-by":"publisher","first-page":"1295a","DOI":"10.5858\/arpa.2020-0341-LE","volume":"144","author":"B Han","year":"2020","unstructured":"Han B, Bhall F, da Silva LF, Van der Heide RS, Love GL, et al. Coronavirus disease 2019 autopsies and personal protective equipment. Arch Pathol Lab Med. 2020;144:1295a\u20131295.","journal-title":"Arch Pathol Lab Med"},{"key":"379_CR10","doi-asserted-by":"publisher","unstructured":"Sperhake J-P. Autopsies of COVID-19 deceased? Absolutely! Leg Med (Tokyo). 2020.\u00a0https:\/\/doi.org\/10.1016\/j.legalmed.2020.101769","DOI":"10.1016\/j.legalmed.2020.101769"},{"key":"379_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jflm.2020.101999","author":"LGM Dijkhuizen","year":"2020","unstructured":"Dijkhuizen LGM, Gelderma HT, Duijst WLJM. Review: The safe handling of a corpse (suspected) with COVID-19. J Forensic Leg Med. 2020. https:\/\/doi.org\/10.1016\/j.jflm.2020.101999.","journal-title":"J Forensic Leg Med"},{"key":"379_CR12","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, et al. Dying with SARS-CoV-2 infection\u2014an autopsy study of the first consecutive 80 cases in Hamburg. Germany Int J Leg Med. 2020;134:1275\u201384.","journal-title":"Germany Int J Leg Med"},{"key":"379_CR13","doi-asserted-by":"crossref","unstructured":"Fitzek A, Sperhake J, Edler C, Schr\u00f6der AS, Heinemann A, et al. Evidence for systematic autopsies in COVID-19 positive deceased. Case report of the first German investigated COVID-19 death. Rechtsmedizin. 2020;184\u20139.","DOI":"10.1007\/s00194-020-00401-4"},{"key":"379_CR14","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1007\/s00428-020-02872-y","volume":"477","author":"F Heinrich","year":"2020","unstructured":"Heinrich F, Sperhake J-P, Heinemann A, Mushumba H, Lennartz M, et al. Germany`s first COVID-19 deceased: a 59-year-old man presenting with diffuse alveolar damage due to SARS-CoV-2 infection. Virchows Arch. 2020;477:335\u20139.","journal-title":"Virchows Arch"},{"key":"379_CR15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104390","author":"D N\u00f6rz","year":"2020","unstructured":"N\u00f6rz D, Fischer N, Schultze A, Kluge S, Mayer-Runge U, et al. Clinical evaluation of a SARS-CoV-2 RT-PCR assay on a fully automated system for rapid on-demand testing in the hospital setting. J Clin Virol. 2020. https:\/\/doi.org\/10.1016\/j.jcv.2020.104390.","journal-title":"J Clin Virol"},{"key":"379_CR16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104650","author":"D N\u00f6rz","year":"2020","unstructured":"N\u00f6rz D, Frontzek A, Eigner U, Oestereich L, Wichmann D, et al. Pushing beyond specifications: Evaluation of linearity and clinical performance of the cobas 6800\/8800 SARS-CoV-2 RT-PCR assay for reliable quantification in blood and other materials outside recommendations. J Clin Virol. 2020. https:\/\/doi.org\/10.1016\/j.jcv.2020.104650.","journal-title":"J Clin Virol"},{"key":"379_CR17","first-page":"e00926","volume":"58","author":"MJ Loeffelholz","year":"2020","unstructured":"Loeffelholz MJ, Alland D, Butler-Wu SM, Pandey U, Perno CF, et al. Multicenter evaluation of the Cepheid Xpert Xpress SARS-CoV-2 Test. J Clin Microbiol. 2020;58:e00926-e1020.","journal-title":"J Clin Microbiol"},{"key":"379_CR18","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2020.25.9.2000152","author":"S Pfefferle","year":"2020","unstructured":"Pfefferle S, Reucher S, N\u00f6rz D, L\u00fctgehetmann M. Evaluation of a quantitative RT-PCR assay for the detection of the emerging coronavirus SARS-CoV-2 using a high throughput system. Euro Surveill. 2020. https:\/\/doi.org\/10.2807\/1560-7917.ES.2020.25.9.2000152.","journal-title":"Euro Surveill"},{"key":"379_CR19","doi-asserted-by":"publisher","first-page":"e00520","DOI":"10.1128\/MRA.00520-20","volume":"9","author":"S Pfefferle","year":"2020","unstructured":"Pfefferle S, Huang J, N\u00f6rz D, Indenbirken D, L\u00fctgehetmann M, et al. Complete genome sequence of a SARS-CoV-2 strain isolated in Northern Germany. Microbiol Resour Announc. 2020;9:e00520-e620.","journal-title":"Microbiol Resour Announc"},{"key":"379_CR20","doi-asserted-by":"publisher","unstructured":"Chin AWH, Chu JTS, Perera MRA, Hui KPY, Yen H-LY, et al. Stability of SARS-CoV-2 in different environmental conditions. Lancet Microbe. 2020;\u00a0https:\/\/doi.org\/10.1016\/S2666-5247(20)30003-3","DOI":"10.1016\/S2666-5247(20)30003-3"},{"key":"379_CR21","doi-asserted-by":"crossref","unstructured":"Liu Y, Li T, Deng, Y Liu S, Zhang D, et al. Stability of SARS-CoV-2 on environmental surfaces and in human excreta. J Hosp Infect. 2021;107:105\u20137.","DOI":"10.1016\/j.jhin.2020.10.021"},{"key":"379_CR22","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2004973","author":"N Van Doremalen","year":"2020","unstructured":"Van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020. https:\/\/doi.org\/10.1056\/NEJMc2004973.","journal-title":"N Engl J Med"},{"key":"379_CR23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0008831","author":"DE Harbourt","year":"2020","unstructured":"Harbourt DE, Haddow AD, Piper AE, Bloomfield H, Kearney BJ, et al. Modeling the stability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on skin, currency, and clothing. PLoS Negl Trop Dis. 2020. https:\/\/doi.org\/10.1371\/journal.pntd.0008831.","journal-title":"PLoS Negl Trop Dis"},{"key":"379_CR24","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.3390\/jcm9051259","volume":"9","author":"C Pomara","year":"2020","unstructured":"Pomara C, Li Volti G, Cappello F. COVID-19 deaths: Are we sure it is pneumonia? Please, autopsy, autopsy, autopsy! J Clin Med. 2020;9:1259.","journal-title":"J Clin Med"},{"key":"379_CR25","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1007\/s00428-020-02828-2","volume":"476","author":"A Sapino","year":"2020","unstructured":"Sapino A, Facchetti F, Bonoldi E, Gianatti A, Barbareschi M, et al. The autopsy debate during the COVID-19 emergency: the Italian experience. Virchows Arch. 2020;476:821\u20133.","journal-title":"Virchows Arch"},{"key":"379_CR26","first-page":"147","volume":"69","author":"G Teresi\u0144ski","year":"2019","unstructured":"Teresi\u0144ski G, Jurek T. Recommendations of the Polish Society of Forensic Medicine and Criminology and National Consultant for Forensic Medicine with regard to performing forensic post-mortem examinations in case of confirmed COVID-19 disease and suspected SARS CoV-2 infections. Arch Med Sadowej Kryminol. 2019;69:147\u201357.","journal-title":"Arch Med Sadowej Kryminol"},{"key":"379_CR27","doi-asserted-by":"publisher","DOI":"10.1007\/s12024-020-00341-1","author":"J Baj","year":"2020","unstructured":"Baj J, Ciesielka M, Buszewicz G, Maciejewski R, Budzy\u0144ska B, et al. COVID-19 in the autopsy room\u2013requirements, safety, recommendations and pathological findings. Forensic Sci Med Pathol. 2020. https:\/\/doi.org\/10.1007\/s12024-020-00341-1.","journal-title":"Forensic Sci Med Pathol"},{"key":"379_CR28","unstructured":"Robert Koch Institute. Empfehlungen zum Umgang mit SARS-CoV-2-infizierten Verstorbenen. 2021. https:\/\/www.rki.de\/DE\/Content\/InfAZ\/N\/Neuartiges_Coronavirus\/Verstorbene.html. Accessed 19 Jan 2021."}],"container-title":["Forensic Science, Medicine and Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12024-021-00379-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12024-021-00379-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12024-021-00379-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T20:43:40Z","timestamp":1630701820000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12024-021-00379-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,2]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["379"],"URL":"https:\/\/doi.org\/10.1007\/s12024-021-00379-9","relation":{},"ISSN":["1547-769X","1556-2891"],"issn-type":[{"value":"1547-769X","type":"print"},{"value":"1556-2891","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,2]]},"assertion":[{"value":"7 April 2021","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 June 2021","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the ethics commission of the Hamburg Medical Association (PV7311).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}