The purpose of this rapid review was to identify and examine evidence on the risk of transmission from handling the bodies of deceased persons with suspected or confirmed COVID-19. The review includes 12 studies (including 1 preprint): 4 observational studies (with laboratory components) and 8 laboratory studies in autopsy settings (search up to 17 March 2021).
Evidence from laboratory studies conducted in autopsy settings suggests that SARSCoV-2 can persist in body fluids from the respiratory tract of deceased persons with confirmed COVID-19. However, more research is needed to understand the risk of transmission from contact with the body fluids of deceased persons with COVID-19 and its association with factors such as disease severity, disease duration and post-mortem interval.
Evidence from 3 case series suggests that the risk of transmission from the deceased in autopsy settings with strict infection control protocols is low. Evidence from a prevalence study in mortuary and cemetery workers in Qatar showed high infection rates, although the results suggested that transmission might have occurred in the community rather than from handling bodies of COVID-19 cases.
No epidemiological investigations reporting on transmission from handling bodies of COVID-19 cases were identified, potentially indicating that clusters of COVID-19 infection amongst persons handling the bodies of the deceased has not been reported. However, this does not constitute evidence of absence of risk.
Nearly all studies were conducted in autopsy settings and contained small samples, which limits their applicability to non-clinical settings. In particular, the level of infection control measures in place in these studies do not allow us to infer whether there is a risk of transmission from handling the bodies of deceased persons with suspected or confirmed COVID-19.