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SARS-CoV-2 in the knee joint: a cadaver study


1, 2, 3, 4, 5, 6, 7, 8, 9

 

  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. Pathology Unit, Department of Biomedical and Clinical Sciences, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy.
  5. Microbiology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy.
  6. Rheumatology Department, Università Politecnica delle Marche, Jesi, Italy.
  7. Rheumatology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy.
  8. Microbiology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy.
  9. Orthopaedic and Traumatology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy.

CER14652
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PMID: 34665699 [PubMed]

Received: 23/03/2021
Accepted : 26/03/2021
In Press: 13/10/2021

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.

Rheumatology Article