Mild and asymptomatic cases of COVID-19 are potential threat for faecal–oral transmission

Teixeira, Samuel Cota

doi:10.1016/j.bjid.2020.06.003

Cited by 16 publications

(21 citation statements)

References 4 publications

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“… 16 , 17 , 18 , 19 Additionally, the potential for transmission of SARS-CoV-2 via stool has led to concerns regarding the possible transmission as part of an FMT procedure, particularly with the possibility of asymptomatic shedding in stool. 20 , 21 , 22 , 23 Therefore, SARS-CoV-2 testing needs to be incorporated into FMT donor screening protocols in the COVID-19 era. 5 , 6 , 8 Here, we report the development and validation of a method for the detection of SARS-CoV-2 RNA in healthy human stool.…”

Section: Discussionmentioning

confidence: 99%

A method for detection of SARS-CoV-2 RNA in healthy human stool: a validation study

Coryell¹,

Iakiviak²,

Pereira³

et al. 2021

The Lancet Microbe

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Background Faecal shedding of SARS-CoV-2 has raised concerns about transmission through faecal microbiota transplantation procedures. Validation parameters of authorised tests for SARS-CoV-2 RNA detection in respiratory samples are described in product labelling, whereas the published methods for SARS-CoV-2 detection from faecal samples have not permitted a robust description of the assay parameters. We aimed to develop and validate a test specifically for detection of SARS-CoV-2 in human stool. Methods In this validation study, we evaluated performance characteristics of a reverse transcriptase real-time PCR (RT-rtPCR) test for detection of SARS-CoV-2 in human stool specimens by spiking stool with inactivated SARS-CoV-2 material. A modified version of the US Centers for Disease Control and Prevention RT-rtPCR SARS-CoV-2 test was used for detection of viral RNA. Analytical sensitivity was evaluated in freshly spiked stool by testing two-fold dilutions in replicates of 20. Masked samples were tested by a second laboratory to evaluate interlaboratory reproducibility. Short-term (7-day) stability of viral RNA in stool samples was assessed with four different stool storage buffers (phosphate-buffered saline, Cary-Blair medium, Stool Transport and Recovery [STAR] buffer, and DNA/RNA Shield) kept at −80°C, 4°C, and ambient temperature (approximately 21°C). We also tested clinical stool and anal swab specimens from patients who were SARS-CoV-2 positive by nasopharyngeal testing. Findings The lower limit of detection of the assay was found to be 3000 viral RNA copies per g of original stool sample, with 100% detection across 20 replicates assessed at this concentration. Analytical sensitivity was diminished by approximately two times after a single freeze-thaw cycle at −80°C. At 100 times the limit of detection, spiked samples were generally stable in all four stool storage buffers tested for up to 7 days, with maximum changes in mean threshold cycle values observed at −80°C storage in Cary-Blair medium (from 29·4 [SD 0·27] at baseline to 30·8 [0·17] at day 7; p<0·0001), at 4°C storage in DNA/RNA Shield (from 28·5 [0·15] to 29·8 [0·09]; p=0·0019), and at ambient temperature in STAR buffer (from 30·4 [0·24] to 32·4 [0·62]; p=0·0083). 30 contrived SARS-CoV-2 samples were tested by a second laboratory and were correctly identified as positive or negative in at least one of two rounds of testing. Additionally, SARS-CoV-2 RNA was detected using this assay in the stool and anal swab specimens of 11 of 23 individuals known to be positive for SARS-CoV-2. Interpretation This is a sensitive and reproducible assay for detection of SARS-CoV-2 RNA in human stool, with potential uses in faecal microbiota transplantation donor screening, sewage monitoring, and further research into the effects of faecal shedding on the epidemiology of the COVID-19 pandemic. Funding National Institute of Allergy and Infect...

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Section: Discussionmentioning

confidence: 99%

A method for detection of SARS-CoV-2 RNA in healthy human stool: a validation study

Coryell¹,

Iakiviak²,

Pereira³

et al. 2021

The Lancet Microbe

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“…For instance, the infected reported cases have uncertainties due to many factors such sensitivity and specificity of COVID-19 tests [10, 127]. Moreover, asymptomatic cases represent a great uncertainty [31, 43, 52, 62, 90, 100, 124, 132, 7]. Taking into account these uncertainties, we set the initial conditions presented in Table 2.…”

Section: Methodsmentioning

confidence: 99%

“…We use this value based on information from the CDC official website, even though it is mentioned that there is uncertainty in this percentage. We found that there is a large uncertainty in scientific literature regarding this percentage [30, 31, 43, 52, 62, 90, 100, 124, 132, 7]. Therefore, we vary it in order to deal with its uncertainty.…”

Section: Methodsmentioning

confidence: 99%

“…In particular, we include the asymptomatic carriers of the virus, who are nevertheless able to spread the virus. It has been mentioned that asymptomatic people are in some way a key contributor in the spread of the SARS-CoV-2 virus, and are real threat for the control policies [7, 62, 90, 100, 124, 43, 68, 52, 132, 31, 62]. For instance, it has been found that quantitative SARS-CoV-2 viral loads were similarly high for infected individuals with symptoms, pre-symptomatic, or asymptomatic.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of key factors of a SARS-CoV-2 vaccination program: A mathematical modeling approach

Martínez‐Rodríguez

González-Parra

Micó

2021

Preprint

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The administration of vaccines against the coronavirus disease 2019 (COVID-19) just started in early December of 2020. Currently, there are only a few approved vaccines, each with different efficacies and mechanisms of action. Moreover, vaccination programs in different regions may vary due to differences in implementation, for instance, simply the availability of the vaccine. In this article, we study the impact of the pace of vaccination and the intrinsic efficacy of the vaccine on prevalence, hospitalizations, and deaths related to the SARS-CoV-2 virus. Then we study different potential future scenarios regarding the burden of the COVID-19 pandemic in the near future. We construct a compartmental mathematical model and use computational methodologies to study these different scenarios. Thus, we are able identify some key factors to reach the aims of the vaccination programs. We use some metrics related to the outcomes of the COVID-19 pandemic in order to assess the impact of the efficacy of the vaccine and the pace of the vaccine inoculation. We found that both factors have a high impact on the outcomes. However, the rate of vaccine administration has a higher impact in reducing the burden of the COVID-19 pandemic. This result shows that health institutions need to focus in increasing the vaccine inoculation pace and create awareness in the population about the importance of COVID-19 vaccines.

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“…[ 15 ] Epidemiological investigations revealed a cluster of outbreaks caused by asymptomatic infections, which made asymptomatic patients a threat to the spread of the epidemic. [ 16 , 17 ]…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of traditional Chinese medicine combined with routine western medicine for the asymptomatic novel coronavirus disease (COVID–19)

Wang

Zhu

Sun³

et al. 2020

Medicine

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Background: The number of patients infected with novel coronavirus disease (COVID–19) has exceeded 10 million in 2020, and a large proportion of them are asymptomatic. At present, there is still no effective treatment for this disease. Traditional Chinese medicine (TCM) shows a good therapeutic effect on COVID–19, especially for asymptomatic patients. According to the search results, we found that although there are many studies on COVID–19, there are no studies targeting asymptomatic infections. Therefore, we design a network meta-analysis (NMA) to evaluate the therapeutic effect of TCM on asymptomatic COVID–19. Methods: We will search Chinese and English databases to collect all randomized controlled trials (RCTs) of TCM combined with conventional western medicine or using only TCM to treat asymptomatic COVID–19 from December 2019 to July 2020. Then, two investigators will independently filter the articles, extract data, and evaluate the risk of bias. We will conduct a Bayesian NMA to evaluate the effects of different therapies. All data will be processed by Stata 16.0 and WinBUGS. Results: This study will evaluate the effectiveness of various treatments for asymptomatic COVID–19. The outcome indicators include the time when the nucleic acid turned negative, the proportion of patients with disease progression, changes in laboratory indicators, and the side effects of drugs. Conclusion: This analysis will further improve the treatment of asymptomatic COVID–19. INPLASY registration number: INPLASY202070022.

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Mild and asymptomatic cases of COVID-19 are potential threat for faecal–oral transmission

Cited by 16 publications

References 4 publications

A method for detection of SARS-CoV-2 RNA in healthy human stool: a validation study

A method for detection of SARS-CoV-2 RNA in healthy human stool: a validation study

Analysis of key factors of a SARS-CoV-2 vaccination program: A mathematical modeling approach

Efficacy and safety of traditional Chinese medicine combined with routine western medicine for the asymptomatic novel coronavirus disease (COVID–19)

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