Persistent viral shedding of SARS-CoV-2 in faeces - a rapid review

Gupta, Sukanya Sen; Parker, Jody; Smits, Stephanie; Underwood, Jonathan; Dolwani, Sunil

doi:10.1101/2020.04.17.20069526

Cited by 42 publications

(45 citation statements)

References 42 publications

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“…We tested for SARS-CoV-2 RNA in urine, nasopharyngeal swab, stool, and CSF of the neonate, only nasopharyngeal swab and stool sample tested positive with prolonged virus shedding ( Table 2A , Table 2B ). This is consistent with the current literature of children, PCR in stool was positive until 70 days in children [ 8 , 9 , 11 , [39] , [40] , [41] , [42] ]. The duration of viral shedding in neonates is scarce.…”

Section: Discussionsupporting

confidence: 93%

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Case report of a neonate with high viral SARSCoV-2 loads and long-term virus shedding

Slaats¹,

Versteylen²,

Gast³

et al. 2020

Journal of Infection and Public Health

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Background SARS-CoV-2 has spread globally. Currently, literature of SARS-CoV-2 in neonates is scarce. We present a case of a neonate with a high viral load and prolonged virus shedding. Methods Epidemiology, clinical characteristics, treatment, laboratory data and follow-up information and the treatment of a neonate with COVID-19 were recorded. Results A 7-day-old boy was admitted to the hospital with fever, lethargy and apnoea. He was found SARS-CoV-2 RNA positive with an exceptionally high viral load in nasopharyngeal swab and stool. The father and two maternity nurses at home had detectable SARS-CoV-2 RNA as well. Sequencing showed all strains belonged to the same cluster. The father was asymptomatic and the maternity nurses developed symptoms after visiting. In the mother, no SARS-CoV-2 RNA could be found. Six days after admission, the neonate was discharged after clinical improvement with oral antibiotics because of a possible pyelonephritis. Monitoring the course of this infection showed that SARS-CoV-2 RNA was detectable in the nasopharynx until day 19 and in stool until day 42 after symptom onset. Conclusions This case shows that neonates can have a high viral load of SARS-CoV-2 and can shed the virus for over one month in stool. Despite the high viral load in the neonate, the mother and a sibling did not get infected.

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Section: Discussionsupporting

confidence: 93%

“…Furthermore, in children aged between 2 months and 15 years, SARS-CoV-2 RNA could still be detected in their stool in up to 70 days [ 4 , 8 , 9 ]. Data about duration of viral shedding in neonates is scarce [ 10 , 24 , 27 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

Case report of a neonate with high viral SARSCoV-2 loads and long-term virus shedding

Slaats¹,

Versteylen²,

Gast³

et al. 2020

Journal of Infection and Public Health

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“…On top of the aforementioned two modules, the Quantitative Evaluation module was capable to calculate the volume of each pneumonia lesion and its percentage compared to the volume of the entire lung. This module was very helpful to assess the severity of the fibrosis within the lung, thus leading to significant value in clinical practices ( 16 ). Data were expressed as fibrosis volume or the percentage of fibrosis within the entire lung.…”

Section: Methodsmentioning

confidence: 99%

Lower Circulating Interferon-Gamma Is a Risk Factor for Lung Fibrosis in COVID-19 Patients

et al. 2020

Front. Immunol.

119

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Cytokine storm resulting from SARS-CoV-2 infection is one of the leading causes of acute respiratory distress syndrome (ARDS) and lung fibrosis. We investigated the effect of inflammatory molecules to identify any marker that is related to lung fibrosis in coronavirus disease 2019 (COVID-19). Seventy-six COVID-19 patients who were admitted to Youan Hospital between January 21 and March 20, 2020 and recovered were recruited for this study. Pulmonary fibrosis, represented as fibrotic volume on chest CT images, was computed by an artificial intelligence (AI)-assisted program. Plasma samples were collected from the participants shortly after admission, to measure the basal inflammatory molecules levels. At discharge, fibrosis was present in 46 (60.5%) patients whose plasma interferon-γ (IFN-γ) levels were twofold lower than those without fibrosis ( p > 0.05). The multivariate-adjusted logistic regression analysis demonstrated the inverse association risk of having lung fibrosis and basal circulating IFN-γ levels with an estimate of 0.43 ( p = 0.02). Per the 1-SD increase of basal IFN-γ level in circulation, the fibrosis volume decreased by 0.070% ( p = 0.04) at the discharge of participants. The basal circulating IFN-γ levels were comparable with c-reactive protein in the discrimination of the occurrence of lung fibrosis among COVID-19 patients at discharge, unlike circulating IL-6 levels. In conclusion, these data indicate that decreased circulating IFN-γ is a risk factor of lung fibrosis in COVID-19.

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“…The high rate of asymptomatic infected individuals (Al-Tawfiq, 2020) has challenged the estimation of infection spread basing on survey on ill patients, and alternative approaches, such as wastewater-based epidemiology, were proposed (Medema et al, 2020;Randazzo et al, 2020). Since SARS-CoV-2 duration in faecal samples of infected patients is supposed to be high (Gupta et al, 2020;Zhang et al, 2020), the identification and quantification of viral RNA in raw wastewater (WW) could be a reliable marker of infection prevalence in the population indeed, as demonstrated for other viruses (Hovi et al, 2012;Wigginton et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Presence and vitality of SARS-CoV-2 virus in wastewaters and rivers

Rimoldi

Stefani

Gigantiello

et al. 2020

Preprint

120

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Wastewater-based epidemiology has been proposed to monitor the diffusion and trend of SARS-CoV-2 pandemic. In the present study, raw and treated samples from three wastewater treatment plants, and two river samples characterized the Milano Metropolitan Area, Italy, were surveyed for SARS-CoV-2 RNA positivity to real time PCR and infectiveness. Moreover, whole genome sequencing and phylogenetic analysis of isolated strains was performed.Raw wastewater samples resulted positive to PCR amplification, while treated water samples were always negative (four and two samples, respectively, sampled in two dates). Moreover, the rate of positivity in raw wastewater samples decreased after eight days, in congruence with the epidemiological trend estimated for the interested provinces. Virus infectiveness was always not significant, indicating the effectiveness of wastewater treatments, or the natural decay of viral vitality, which implied the absence of significant risk of infection from wastewaters. Samples from receiving rivers (two sites, sampled in the same dates as wastewaters) showed in some cases a positivity to PCR amplification, probably due to non-treated discharges, or the combined sewage overflows. Nevertheless, also for rivers vitality was negligible, indicating the absence of sanitary risks. Phylogenetic analysis of genome indicated that the isolated virus belongs to the most spread strain present in Europe and similar to another strain found in Lombardy.

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Persistent viral shedding of SARS-CoV-2 in faeces - a rapid review

Cited by 42 publications

References 42 publications

Case report of a neonate with high viral SARSCoV-2 loads and long-term virus shedding

Case report of a neonate with high viral SARSCoV-2 loads and long-term virus shedding

Lower Circulating Interferon-Gamma Is a Risk Factor for Lung Fibrosis in COVID-19 Patients

Presence and vitality of SARS-CoV-2 virus in wastewaters and rivers

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