Positive result of Sars‐Cov‐2 in faeces and sputum from discharged patients with COVID‐19 in Yiwu, China

Abstract

Background:With the effective prevention and control of COVID -19 inChina, the number of cured cases increased significantly. Further monitoring of the disease prognosis and effective control of the "relapse" of the epidemic become the next focus of work. To analyse the clinical prognosis of discharged COVID-19 patients by monitoring their SAR-CoV-2 nucleic acid status, which may provide This article is protected by copyright. All rights reserved. Accepted Articleevidence to establish discharge standards and follow-up management for COVID-19 patients. Methods: We included 13 discharged COVID-19 patients who were quarantined for 4-week at home. The patient's daily clinical signs were recorded and sputum and faecal specimens were regularly sent for the detection of SARS-CoV-2 nucleic acid. Results: The time between initial symptoms and meeting discharge criteria was 18 -44 days with an average of 25 ± 6 days. The faecal samples of two patients still tested positive after meeting discharge criteria and the sputum samples of four patients returned positive 5 -14 days after discharge. The rate of a recurring positive test result in samples from the respiratory system was 31%(4/13). Conclusion:Under the present discharge criteria, the high presence of SARS-CoV-2 nucleic acid in faecal and respiratory samples of discharged COVID-19 patients indicate potential infectivity. Therefore, we suggest that faecal virus nucleic acid should be tested as a routine monitoring index for COVID-19 and a negative result be added to the criteria. Simultaneously, we should strengthen the regular follow-up of discharged patients with continuous monitoring of the recurrence of viral nucleic acid. Mainly engaged in the laboratory diagnostic technology research of infectious diseases. Data sharingWith the permission of the corresponding authors, we can provide participant data without names and identifers, but not the study protocol, statistical analysis plan, or informed consent form. Data can be provided after the article is published.Once the data can be made public, the research team will provide an email address for communication. The corresponding authors have the right to decide whether to share the data or not based on the research objectives and plan provided. ContributorsAll the authors participated in generating the idea. Bin Li ＆ Guanhua Hou took part in samples collection. Youjiang Li, Yingping Wu, and Xiaodong Zhang tested all samples by reverse transcription-polymerase chain reaction (RT-PCR) assay.Yuangyuang Yu took part in data collection and interpretation. Youjiang

Can elevated concentrations of ALT and AST predict the risk of ‘recurrence’ of COVID-19?

“…None of these cases showed aggravating clinical symptoms, which was similar to the results demonstrated by Yuan et al [12]. Recent studies reported that fever and cough were the main clinical symptoms observed in COVID-19 patients, who tested positive after discharge [11][12][13]15], which is similar to the results obtained in our study (fever (28, 63.64% vs. 25, 78.13%) and cough (27, 61.36% vs. 21, 65.63%)). However, the differences were not statistically significant.…”

“…It is also observed that some COVID-19 recovery cases may experience a fluctuating period between the relief of clinical symptoms or pulmonary imaging and real recovery from SARS-CoV-2 infections. Some studies have reported that the clinical features and the potential risk factors of SARS-CoV-2 turned positive in patients after they were discharged [7][8][9][10][11][12][13][14][15][16][17]. The reported recurrence rate ranged from 9.09% to 21.43% [7,12,16].…”

“…These results indicated that 'recurrence' of COVID-19 may be a complex disease process with multiple factors. However, the study by Li et al summarised that all recruited 13 discharged patients from COVID-19 infections had normal transaminase concentrations [15]. Subsequently, Ye et al reported that all five recurrent COVID-19 patients had normal ALT and AST serum levels [7].…”

Incidence and Persistence of Viral Shedding in COVID-19 Post-acute Patients With Negativized Pharyngeal Swab: A Systematic Review

“…However, most of these studies did not report the duration data of each tested patient. One study ( 16 ) examined the semen of only one patient, with a negative result, while another study ( 38 ) looked for coronavirus RNA in the breast milk of a breastfeeding woman, also with a negative result. Another study ( 60 ) added the virus search on gastrointestinal tract biopsies (with three positive results out of six biopsies).…”

Comment on “Central Nervous System Involvement by Severe Acute Respiratory Syndrome Coronavirus ‐2 (SARS‐CoV‐2)”

“…Nevertheless, an interesting report by Dr. Talbot's group showed that the viral RNA of another human betacoronavirus, HCoV-OC43, can exist in the mice for at least a year after the initial virus-induced acute encephalitis and continuously cause pathology in the mice (16). In light of this, it will be worthy to take into account of the neuronal reservoir of SARS-CoV-2 virus in the recurrent cases of COVID-19 disease (17,18).…”