Previous research showed SARS-CoV-2 persisting in the body for up to five days post-mortem. A follow-up study by forensic experts reveals the virus can still replicate for as long as 35 hours after death.
In May 2020, forensic pathologists from the University Medical Center Hamburg-Eppendorf's Department of Forensic Medicine in Germany reported SARS-CoV-2 presence in multiple organs—including lungs, liver, pharynx, heart, and kidneys—up to five days after death. Their analysis highlighted pulmonary embolism from blood clots in the pulmonary circulation as a key cause of fatality. Led by Axel Heinemann, the team published a second study in Emerging Infectious Diseases in January 2021. It found SARS-CoV-2 actively replicating in the throats of deceased patients up to 35 hours post-mortem.
The researchers conducted autopsies on 79 bodies with positive PCR tests 2 to 14 days before death, sampling nasopharyngeal swabs on average 17 hours after death. Results showed consistent SARS-CoV-2 RNA levels unaffected by post-mortem interval or viral load. In a subset of 11 cases with short post-mortem intervals (time to 4°C refrigeration), RNA remained stable, with replication confirmed in six patients up to 35 hours after death.
These findings indicate SARS-CoV-2 remains infectious without significant viral load decline over extended periods post-mortem, posing transmission risks during body handling. The authors recommend specialized protocols for managing bodies of virus-infected deceased individuals to protect healthcare and funeral workers.
Study limitations include the small sample size and some patients' severe immunosuppression unrelated to COVID-19, which may have influenced results. The team plans further research on cases with lower viral loads to refine these insights.
