Miriam Grassi1, Valeria Giorgi2, Manuela Nebuloni3, Pietro Zerbi3, Maria Rita Gismondo4, Fausto Salaffi5, Piercarlo Sarzi-Puttini6, Sara Giordana Rimoldi4, Alfonso Manzotti1. 1. Orthopaedic and Traumatology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy. 2. Rheumatology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy. vale.gio@fastwebnet.it. 3. Pathology Unit, Department of Biomedical and Clinical Sciences, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy. 4. Microbiology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy. 5. Rheumatology Department, Università Politecnica delle Marche, Jesi, Italy. 6. Rheumatology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy.
Abstract
OBJECTIVES: Despite the considerable research efforts being made to learn more about COVID-19, little is known about the presence of SARS-CoV-2 genetic material in biological fluids other than respiratory droplets, blood, and feces. The aim of this post-mortem study was to assess the presence of SARS-CoV-2 RNA in the knee synovial fluid, synovial tissue, and bone tissue of COVID-19 patients in order to discover whether the joint is a possible route of transmission during orthopaedic surgical procedures, and clarify the possible role of SARS-CoV-2 as a directly arthritogenic virus. METHODS: Post-mortem synovial fluid, synovial tissue and bone tissue samples were collected from the knees of five patients who died of COVID-19 in our hospital between September and October 2020, and analysed for the presence of SARS-CoV-2 using a commercial real-time polymerase chain reaction (RT-PCR) panel. Quantitative RT-PCR was used to test post-mortem nasopharyngeal swabs of all of the patients. RESULTS: No SARS-CoV-2 RNA was detected in any of the knee samples, despite the positivity of the throat swab. CONCLUSIONS: Our findings indicate that SARS-CoV-2 was not detected in knee synovial fluid, synovial membrane or bone. This makes it unlikely that these are potential sources of contagion, and suggests that SARS-CoV-2 is not directly arthritogenic.
OBJECTIVES: Despite the considerable research efforts being made to learn more about COVID-19, little is known about the presence of SARS-CoV-2 genetic material in biological fluids other than respiratory droplets, blood, and feces. The aim of this post-mortem study was to assess the presence of SARS-CoV-2 RNA in the knee synovial fluid, synovial tissue, and bone tissue of COVID-19 patients in order to discover whether the joint is a possible route of transmission during orthopaedic surgical procedures, and clarify the possible role of SARS-CoV-2 as a directly arthritogenic virus. METHODS: Post-mortem synovial fluid, synovial tissue and bone tissue samples were collected from the knees of five patients who died of COVID-19 in our hospital between September and October 2020, and analysed for the presence of SARS-CoV-2 using a commercial real-time polymerase chain reaction (RT-PCR) panel. Quantitative RT-PCR was used to test post-mortem nasopharyngeal swabs of all of the patients. RESULTS: No SARS-CoV-2 RNA was detected in any of the knee samples, despite the positivity of the throat swab. CONCLUSIONS: Our findings indicate that SARS-CoV-2 was not detected in knee synovial fluid, synovial membrane or bone. This makes it unlikely that these are potential sources of contagion, and suggests that SARS-CoV-2 is not directly arthritogenic.
Authors: Edoardo Guazzoni; Alberto Castelli; Alberto Polizzi; Giacomo Galanzino; Antonio Piralla; Federica Giardina; Fausto Baldanti; Eugenio Jannelli; Laura Caliogna; Gianluigi Pasta; Mario Mosconi; Federico Alberto Grassi Journal: Int J Environ Res Public Health Date: 2022-08-25 Impact factor: 4.614