Contamination of personal protective equipment during COVID-19 autopsies
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Contamination of personal protective equipment during COVID-19 autopsies. / Brandner, Johanna M; Boor, Peter; Borcherding, Lukas; Edler, Carolin; Gerber, Sven; Heinemann, Axel; Hilsenbeck, Julia; Kasajima, Atsuko; Lohner, Larissa; Märkl, Bruno; Pablik, Jessica; Schröder, Ann Sophie; Slotta-Huspenina, Julia; Sommer, Linna; Sperhake, Jan-Peter; von Stillfried, Saskia; Dintner, Sebastian.
In: VIRCHOWS ARCH, Vol. 480, No. 3, 03.2022, p. 519-528.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Contamination of personal protective equipment during COVID-19 autopsies
AU - Brandner, Johanna M
AU - Boor, Peter
AU - Borcherding, Lukas
AU - Edler, Carolin
AU - Gerber, Sven
AU - Heinemann, Axel
AU - Hilsenbeck, Julia
AU - Kasajima, Atsuko
AU - Lohner, Larissa
AU - Märkl, Bruno
AU - Pablik, Jessica
AU - Schröder, Ann Sophie
AU - Slotta-Huspenina, Julia
AU - Sommer, Linna
AU - Sperhake, Jan-Peter
AU - von Stillfried, Saskia
AU - Dintner, Sebastian
N1 - © 2022. The Author(s).
PY - 2022/3
Y1 - 2022/3
N2 - Confronted with an emerging infectious disease at the beginning of the COVID-19 pandemic, the medical community faced concerns regarding the safety of autopsies on those who died of the disease. 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.
AB - Confronted with an emerging infectious disease at the beginning of the COVID-19 pandemic, the medical community faced concerns regarding the safety of autopsies on those who died of the disease. 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.
KW - Autopsy
KW - COVID-19/prevention & control
KW - Humans
KW - Pandemics/prevention & control
KW - Personal Protective Equipment
KW - RNA, Viral/genetics
KW - SARS-CoV-2
U2 - 10.1007/s00428-021-03263-7
DO - 10.1007/s00428-021-03263-7
M3 - SCORING: Journal article
C2 - 34993593
VL - 480
SP - 519
EP - 528
JO - VIRCHOWS ARCH
JF - VIRCHOWS ARCH
SN - 0945-6317
IS - 3
ER -
