Genomic analysis of SARS-CoV-2 in Forensic Autopsy Cases of COVID-19

Various specimens were collected from 18 forensic autopsy cases of SARS-CoV-2 infection. Next generation sequencing determined the complete genome sequences in 15 of 18 cases, although some cases showed severe postmortem changes or degradation of tissue RNA. Intra-host genome diversity of viral genome were identified in one case of COVID-19 death. Accumulation of the single nucleotide variations in the lung of the case suggested the intra-host evolution of SARS-CoV-2. Lung of the case showed diffuse alveolar damage histologically and was positive for SARS-CoV-2 with immunohistochemistry and in situ hybridization, indicating the virus-associated pneumonia. This study provides an insight into the feasibility of genomic analysis of SARS-CoV-2 in forensic autopsy cases and the potential for uncovering important information in COVID-19 deaths, including out-of-hospital deaths.