Bengaluru's first Covid-19 autopsy shows virus absent on surface skin

Autopsy was done to address 3 major questions: presence of virus in the dead body, understanding disease process and the outcome of the process

Bengaluru's first Covid-19 victim autopsy conducted 16-18 hours after the death of a 61-year-old Covid patient showed that the virus was absent from the skin surface but was present in the nose, mouth and the throat.

The autopsy was conducted by head of the Department of Forensic Medicine at Oxford Medical College, Dr Dinesh Rao, sought to address three major questions: presence of virus in the dead body, understanding disease process and the outcome of the disease process.

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An RT PCR test of five swabs from the body revealed different results. One swab was taken from the nose, the second swab was taken from the mouth and the throat, third swab was taken from the surface of the lungs, fourth was taken from the respiratory passages: from the bronchi and the trachea, and the fifth swab was taken from the skin surface, from the face and the neck.

"After my examination what I shockingly found was the virus was still present in the nose, mouth and the throat," Dr Rao said.

Asked about the fear among people who object to the bury Covid-19 patients in their locality, he said new rules were required based on scientific data.

"It's high time we stop following what the ICMR or WHO says. We should conduct our own research. ICMR policies say we should not touch the body but when asked why, they say the WHO says so. What prevents them from conducting such a study? My study concludes that there was no virus present on the face and the neck, then why can't we touch the body?"

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He said "a series of studies" have to be conducted to conclude how long the virus will last and then frame policies whether a Covid patient's dead body can be touched.
Understanding disease process.

Examining the lungs, heart, kidneys, brain, spleen and liver, showed that 'while the lungs are normally spongy in appearance, in this Covid patient, it had the appearance of a hard leather ball.'

"This is an important finding. What we term a 'shock lung' is a severely damaged lung, enlarged in size and firm. But the Covid patient's lung was not enlarged. It was the usual size but firm. Sections of alveoli or air sacs were ruptured. There was also interstitial pneumonia and inflammatory cells. Multiple emboli or blood clots were also found in the blood vessels because of which there was coagulative necrosis of the lungs," he said.

He said the findings also offer insight into treatment regime. "If we connect this patient only to a ventilator, administer antivirals and antibodies, he is going to die, because the basic underlying pathology is a thrombo embolic phenomenon, which needs to be treated first and then oxygen therapy has to be administered. These should go together. Failing to give thrombolytic therapy will kill the patient," Dr Rao said.