{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:40:01Z","timestamp":1756377601682,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,10,12]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>During the global pandemic of COVID-19 accurate diagnosis of the infection by demonstrating SARS-CoV-2 viral RNA by PCR in specimens is crucial for therapeutic and preventative interventions. There have been instances where nasal and throat swabs have been negative despite the patient having typical clinical and radiological findings compatible with the disease. We report a case of a man in his late 50s, brought to the hospital following a cardiac arrest and prolonged unsuccessful resuscitation. The history was typical for COVID-19 with fever for 10 days and worsening shortness of breath. His throat and nasal swabs (after death) were negative for SARS-CoV-2. A limited diagnostic autopsy was performed after 27 days, and lung swabs confirmed presence of SARS-CoV-2. This case highlights the importance of lung swabs when initial upper respiratory tract swabs are negative and proves that the virus can be detected from dead human tissue almost a month later.<\/jats:p>","DOI":"10.1136\/bcr-2020-237446","type":"journal-article","created":{"date-parts":[[2020,10,31]],"date-time":"2020-10-31T16:40:23Z","timestamp":1604162423000},"page":"e237446","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Undetectable SARS-CoV-2 in a nasopharyngeal swab but persistent viral RNA from deep lung swabs: findings from an autopsy"],"prefix":"10.1136","volume":"13","author":[{"given":"Prema","family":"Seetulsingh","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, Watford General Hospital, Watford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4544-1419","authenticated-orcid":false,"given":"Chiranthi Iresha","family":"Kannangara","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Watford General Hospital, Watford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Richman","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Watford General Hospital, Watford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,10,31]]},"reference":[{"key":"2025082803225602000_13.10.e237446.1","unstructured":"Coronavirus Update (Live): 27,761,512 Cases and 902,306 Deaths from COVID-19 Virus Pandemic - Worldometer. Available: https:\/\/www.worldometers.info\/coronavirus\/ [Accessed 9 Sep 2020]."},{"key":"2025082803225602000_13.10.e237446.2","doi-asserted-by":"crossref","DOI":"10.1128\/JCM.00512-20","article-title":"Laboratory diagnosis of COVID-19: current issues and challenges","volume":"58","author":"Tang","year":"2020","journal-title":"J Clin Microbiol"},{"key":"2025082803225602000_13.10.e237446.3","doi-asserted-by":"crossref","DOI":"10.1016\/j.idcr.2020.e00791","article-title":"A cautionary tale of false-negative nasopharyngeal COVID-19 testing","volume":"20","author":"Bullis","year":"2020","journal-title":"IDCases"},{"key":"2025082803225602000_13.10.e237446.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1808"},{"key":"2025082803225602000_13.10.e237446.5","doi-asserted-by":"crossref","unstructured":"Kojima N , Turner F , Slepnev V , et al . Self-Collected oral fluid and nasal swabs demonstrate comparable sensitivity to clinician collected nasopharyngeal swabs for Covid-19 detection. medRxiv 2020.","DOI":"10.1101\/2020.04.11.20062372"},{"key":"2025082803225602000_13.10.e237446.6","first-page":"1843","article-title":"Detection of SARS-CoV-2 in different types of clinical specimens","volume":"323","author":"Wang","year":"2020","journal-title":"JAMA"},{"key":"2025082803225602000_13.10.e237446.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2001737"},{"key":"2025082803225602000_13.10.e237446.8","first-page":"23","article-title":"Upper respiratory tract sampling in COVID-19","volume":"42","author":"Mawaddah","year":"2020","journal-title":"Malays J Pathol"},{"key":"2025082803225602000_13.10.e237446.9","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1080\/22221751.2020.1729071","article-title":"Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes","volume":"9","author":"Zhang","year":"2020","journal-title":"Emerg Microbes Infect"},{"key":"2025082803225602000_13.10.e237446.10","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2020-206522"},{"key":"2025082803225602000_13.10.e237446.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2004973"},{"key":"2025082803225602000_13.10.e237446.12","unstructured":"CDC . Coronavirus disease 2019 (COVID-19), 2020. Available: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/guidance-postmortem-specimens.html [Accessed 16 May 2020]."},{"key":"2025082803225602000_13.10.e237446.13","doi-asserted-by":"publisher","DOI":"10.1126\/science.275.5307.1793"},{"key":"2025082803225602000_13.10.e237446.14","first-page":"86","article-title":"The origin and virulence of the 1918 \"Spanish\" influenza virus","volume":"150","author":"Taubenberger","year":"2006","journal-title":"Proc Am Philos Soc"},{"key":"2025082803225602000_13.10.e237446.15","article-title":"The Laboratory Diagnosis of COVID-19-- Frequently-Asked Questions","author":"Fang","year":"2020","journal-title":"Clin Infect Dis"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-237446","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:23:07Z","timestamp":1756376587000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-237446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":15,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,10,31]]},"published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1136\/bcr-2020-237446"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-237446","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,10]]}}}