Can SARS-CoV-2 be transmitted via faeces?

Abstract

Purpose of review COVID-19 patients can present gastrointestinal symptoms, being diarrhoea one of the most frequent, suggesting intestinal health can be impacted by COVID-19. Here, we will discuss whether there is a correlation between the presence of SARS-CoV-2 RNA in faeces and diarrhoea, the relevance of gastrointestinal symptoms in disease diagnosis and transmission, and how COVID-19 can impact the gut microbial balance. Recent findings SARS-CoV-2 RNA has been reported in faeces or rectal swabs of COVID-19 patients with and without diarrhoea, suggesting faecal shedding can occur independently of gastrointestinal symptoms. However, the presence of the virus in the intestine can persist beyond its presence in the respiratory tract, with some reports suggesting that SARS-CoV-2 in the faeces can be infectious. COVID-19 can impact the gut microbiota causing an enhancement of biosynthesis pathways that favour the expansion of bacterial pathogens in the inflamed gut, and causing a decline in commensals involved in the human immune response. Summary Gastrointestinal symptoms may be the first indication of COVID-19. SARS-CoV-2 in faeces can potentiate routes of disease transmission, particularly as the high viral loads reported in patients with severe illness suggest virus replication in the intestine may be possible.

Post-acute sequelae of COVID-19: A metabolic perspective

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Therapeutic Targeting of Innate Immune Receptors Against SARS-CoV-2 Infection

“…Individuals infected with SARS-CoV-2 exhibit gastrointestinal symptoms including diarrhea, nausea, vomiting, and abdominal pain. This observation also points to the possibility that SARS-CoV-2 is an enteric virus (Ding and Liang, 2020;Moura et al, 2022). There is a report of persistent virus shedding by children through feces after their nasopharyngeal swabs tested negative for viral RNA (Xu et al, 2020b).…”

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“…Although we did not find direct evidence for transmission of the virus between the owner and the dog in this case, it has been reported that SARS-CoV-2 has repeatedly spilled over from humans to companion animals, highlighting the need for enhanced surveillance in animals. It is concerning that companion animals could become reservoir species of SARS-CoV-2 since they are susceptible to infection and could excrete infectious virus [12].…”