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SARS-CoV-2 in the knee joint: a cadaver study
M. Grassi1, V. Giorgi2, M. Nebuloni3, P. Zerbi4, M.R. Gismondo5, F. Salaffi6, P. Sarzi-Puttini7, S.G. Rimoldi8, A. Manzotti9
- Orthopaedic and Traumatology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy.
- Rheumatology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy. vale.gio@fastwebnet.it
- Pathology Unit, Department of Biomedical and Clinical Sciences, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy.
- Pathology Unit, Department of Biomedical and Clinical Sciences, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy.
- Microbiology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy.
- Rheumatology Department, Università Politecnica delle Marche, Jesi, Italy.
- Rheumatology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy.
- Microbiology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy.
- Orthopaedic and Traumatology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy.
CER14652
2022 Vol.40, N°3
PI 0608, PF 0612
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PMID: 34665699 [PubMed]
Received: 23/03/2021
Accepted : 26/03/2021
In Press: 13/10/2021
Published: 22/03/2022
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.