Excretion of SARS-CoV-2 through faecal specimens

Abstract

Coronavirus disease 2019 (COVID-19) has become a pandemic with increasing numbers of cases worldwide. SARS-CoV-2, the causative virus of COVID-19, is mainly transmitted through respiratory droplets or through direct and indirect contact with an infected person. The possibility of potential faecal-oral transmission was investigated in this study. We collected 258 faecal specimens from nine provinces in China and detected the nucleic acid of SARS-CoV-2 using real-time RT–PCR. Vero cells were used to isolate the virus from SARS-CoV-2 nucleic acid positive samples, after which sequencing of Spike gene in eight samples was performed. In all, 93 of 258 (36%) stool samples were positive for SARS-CoV-2 RNA. The positive rates of critical, severe, moderate, and mild patients were 54.4%, 56.1%, 30.8%, and 33.3%, respectively. The content of nucleic acid increased within 2 weeks after the onset of the disease. From the perspective of clinical typing, the nucleic acid can be detected in the faeces of critical patients within two weeks and until four to five weeks in the faeces of severe and mild patients. SARS-CoV-2 was isolated from stool specimens of two severe patients. Four non-synonymous mutations in Spike gene were newly detected in three stool samples. A small number of patients had strong faecal detoxification ability. The live virus in faeces could be an important source of contamination, which may lead to infection and further spread in areas with poor sanitary conditions. The findings of this study have public health significance and they should be considered when formulating disease control strategies.

Analysis of viral load in different specimen types and serum antibody levels of COVID-19 patients

“…It is recommended to test anal swab, because in this study, except for nasopharyngeal swabs, SARS-CoV-2 was mostly detected in anal swabs. Moreover, several studies have characterized the presence of live virus in feces [17][18][19], indicating that SARS-CoV-2 may be transmitted by fecal route. Notably, Wang et al [19] failed to isolate virus in feces specimens collected at later time points of disease onset.…”

Impact of both socioeconomic level and occupation on antibody prevalence to SARS‐CoV‐2 in an Egyptian cohort: The first episode

“…In addition, they also work, which makes them equally exposed to infection as males. Moreover, it has been reported that the virus is excreted in the feces of infected human subjects 26 …”

Live SARS‐CoV‐2 is difficult to detect in patient aerosols

“…Despite the demonstrated challenges in capturing suspended live virus, respiratory transmission is now thought of as the primary mode of SARS‐CoV‐2 infection. By contrast, SARS‐CoV‐2 has been readily cultured from nasopharyngeal (NP) swabs, saliva, blood, stool, and semen 4,10‐12 . Mounting evidence indicates that COVID‐19 patients are most infectious within the first eight days following symptom onset, 4,12,13 with some outliers shedding live virus for up to 18 days 13,14 .…”