Volume 30, Number 8—August 2024
Research Letter
Infective SARS-CoV-2 in Skull Sawdust at Autopsy, Finland
, Suvi Kuivanen1, Teemu Smura, Henri Puttonen, Eliisa Kekäläinen, Antti Sajantila, Liisa Myllykangas, Anu Kantele, Olli Vapalahti, Mikko I. Mäyränpää2, and Olli Carpén2
Table
SARS-CoV-2 distribution among cohort of 22 autopsied deceased persons with COVID-19 who had skull sawdust sampling, Finland*
| Case no. | Airway |
Nonairway |
CNS PCR and culture | Skull sawdust |
Autopsy table |
||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| PCR | Culture | PCR | Culture | PCR | Culture | PCR | Culture | ||||
| 1 | + | – | – | – | – | – | – | + | – | ||
| 2 | + | – | – | – | – | – | – | – | – | ||
| 3 | + | – | – | – | – | – | – | – | – | ||
| 4 | + | – | – | – | – | – | – | – | – | ||
| 5 | + | – | – | – | – | – | – | – | – | ||
| 6 | + | + | – | – | – | – | – | + | – | ||
| 7 | + | + | + | – | – | – | – | + | – | ||
| 8 | + | + | + | – | – | – | – | – | – | ||
| 9† | + | + | + | – | – | + | + | + | – | ||
| 10 | + | + | – | – | – | – | – | + | – | ||
| 11 | + | + | + | + | – | – | – | + | – | ||
| 12 | + | + | – | – | – | + | – | – | – | ||
| 13 | + | – | – | – | – | – | – | – | – | ||
| 14 | + | + | + | + | – | – | – | + | – | ||
| 15 | + | + | + | – | – | – | – | + | + | ||
| 16 | + | + | + | – | – | – | – | + | + | ||
| 17 | + | – | – | – | – | – | – | + | – | ||
| 18 | + | + | + | – | – | – | – | + | – | ||
| 19 | + | – | + | – | – | – | – | + | – | ||
| 20 | + | + | + | – | – | – | – | – | – | ||
| 21 | + | – | – | – | – | – | – | – | – | ||
| 22 |
+ |
+ |
– |
– |
– |
– |
– |
+ |
+ |
||
| Positive samples/total no. samples (%) | 22/22 (100) | 13/22 (59.1) | 10/22 (45.5) | 2/22 (9.1) | 0/22 | 2/22 (9.1) | 1/22 (4.5) | 13/22 (59.1) | 3/22 (13.6) | ||
*The pooled sample category per patient was considered positive if a single positive tissue sample of that category was found (copy number cutoff value 10; Appendix). Airway refers to tissues relating to the airway system (i.e., nasopharynx, bronchi, lungs, tonsils, sclera, and airway-associated cervical and parabronchial lymph nodes). Autopsy table refers to the contaminated autopsy table and the outer surfaces of the organ block, representing the main working area and target of showering with water. Only a limited number of cases showed culture positivity (Ct value reduction after culture compared with initial Ct value; Appendix) in general; skull positivity was scarce, whereas the autopsy table was more often positive by both PCR and viral culture. †Test results showed culture positivity in the cranial sawdust sample and low-level nonairway PCR-positivity limited to skeletal muscle and salivary gland tissues, indicating limited systemic viral involvement (Appendix Table).
1Current affiliation: Charité-Universitätsmedizin Berlin, Berlin, Germany.
2These senior authors contributed equally to this article.