SARS-CoV-2 RNA screening in routine pathology specimens

medRxiv

Abstract

Summary Virus detection methods are important to cope with the SARS-CoV-2 pandemics. Apart from the lung, SARS-CoV-2 was detected in multiple organs in severe cases. Less is known on organ tropism in patients developing mild or no symptoms, and some of such patients might be missed in symptom-indicated swab testing. Here we tested and validated several approaches and selected the most reliable RT-PCR protocol for the detection of SARS-CoV-2 RNA in patients’ routine diagnostic formalin-fixed and paraffin-embedded (FFPE) specimens available in pathology, to assess a) organ tropism in samples from COVID-19-positive patients, b) unrecognized cases in selected tissues from negative or not-tested patients during a pandemic peak, and c) retrospectively, pre-pandemic lung samples. We identified SARS-CoV-2 RNA in four samples from confirmed COVID-19 patients, in two gastric biopsies, one colon resection, and one pleural effusion specimen, while all other specimens, particularly from patients with mild COVID-19 disease course, were negative. In the pandemic peak cohort, we identified one previously unrecognized COVID-19 case in tonsillectomy samples. All pre-pandemic lung samples were negative. In conclusion, SARS-CoV-2 RNA detection in FFPE pathology specimens can potentially improve surveillance of COVID-19, allow retrospective studies, and advance our understanding of SARS-CoV-2 organ tropism and effects.

Authors 15

1. Saskia Freifrau von Stillfried Aachen Institute of Pathology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany

2. Sophia Villwock Aachen Institute of Pathology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany

3. Roman David Bülow Aachen Institute of Pathology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany

4. Sonja Djudjaj Aachen Institute of Pathology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany

5. Eva Miriam Buhl Aachen Electron Microscopy Facility Institute of Pathology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Electron Microscopy Facility, RWTH Aachen University Hospital, Aachen, Germany

   Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany

6. Angela Maurer Aachen Institute of Pathology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany

7. Nadina Ortiz‐Brüchle Aachen Institute of Pathology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany

8. Peter Celec

   Slovak Academy of Sciences · Biomedical Research Center of the Slovak Academy of Sciences · Institute of Virology of the Slovak Academy of Sciences · Comenius University Bratislava

   Affiliation as printed

   Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia

   Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia

   Institute of Virology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia

9. Barbara M. Klinkhammer Aachen Institute of Pathology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany

10. Dickson W.L. Wong Aachen Institute of Pathology

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany

11. Claudio Cacchi Aachen Institute of Pathology

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany

12. Till A. Braunschweig Aachen Institute of Pathology

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany

13. Ruth Knüchel‐Clarke Aachen Institute of Pathology

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany

14. Edgar Dahl Aachen Institute of Pathology

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany

    RWTH centralized Biomaterial Bank (RWTH cBMB), RWTH Aachen University Hospital, Aachen, Germany

15. Peter Boor corresponding Aachen Departments of Nephrology and Immunology Electron Microscopy Facility Institute of Pathology

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Departments of Nephrology and Immunology, RWTH Aachen University Hospital, Aachen, Germany

    Electron Microscopy Facility, RWTH Aachen University Hospital, Aachen, Germany

    Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany