Transmission Routes Analysis of SARS-CoV-2: A Systematic Review and Case Report

Abstract

The global outbreak of SARS-CoV-2 spread rapidly throughout the world which transmitted among humans through various routes. Asymptomatic (carriers) and possible fecal-oral transmission, resulted into a large-scale spread. These issues pose great challenges to disease diagnosis and epidemic control. We obtained data on 29 cases of COVID-19 patients in Jinan, China, and reported the clinical data of asymptomatic patients confirmed with stool samples positive. Some patients with gastrointestinal infections are secondary to pulmonary infections, and during the patients' recovery period, the virus may still existin the patient's gastrointestinal tract over 7 days. We combined with epidemiological and clinical data of asymptomatic patients to analyze the possible routes of viral transmission and infection, including eyes-nose, hands-eyes, fecal-oral, and eyes-oral, et al., thus first presented the two-way transmission through eyes-oral. Through associating infection symptoms with the transmission routes of virus and the patient course of the disease, we expect to provide guidelines for clinical diagnosis and the basis for suppressing the spread of the virus and antiviral treatment.

Modes of Transmission of Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) and Factors Influencing on the Airborne Transmission: A Review

“…The rapid outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is spread via airborne, droplet, contact, and fecal–oral transmission modes constitutes a worldwide and disruptive challenge to societies [ 1 , 2 ]. Both symptomatic and asymptomatic carriers have been recognized to transmit the SARS-CoV-2 virus via various modes of transmission [ 3 , 4 , 5 ], causing severe respiratory infections among patients receiving medical care in hospitals [ 6 , 7 , 8 , 9 , 10 , 11 ]. Hence, the COVID-19 outbreak has been declared a global public health emergency of international concern by the World Health Organization (WHO) [ 12 , 13 , 14 ].…”

Involvement of the nervous system in COVID-19: The bell should toll in the brain

“…Immunohistology studies have revealed the expression levels of ACE2 receptors in the small intestine [ 53 ]. With such an extensive distribution of ACE2 receptors, COVID-19 cases have bridged the connection of disease with the disruption of the digestive system expressed in terms of diarrhea, nausea and vomiting, and abdominal pain [ 54 ]. This could be a reason for the presence of SARS-CoV-2 in the fecal samples until 5 weeks after the patients testing negative for the upper respiratory swab samples [ 54 , 55 ].…”

“…With such an extensive distribution of ACE2 receptors, COVID-19 cases have bridged the connection of disease with the disruption of the digestive system expressed in terms of diarrhea, nausea and vomiting, and abdominal pain [ 54 ]. This could be a reason for the presence of SARS-CoV-2 in the fecal samples until 5 weeks after the patients testing negative for the upper respiratory swab samples [ 54 , 55 ]. GI tract is connected to the central nervous system through the enteric neuronal network regulated by the vagus nerve and sympathetic nerve.…”

Maintaining plasma quality and safety in the state of ongoing epidemic – The role of pathogen reduction

“…There was also no development of COVID-19 disease in blood recipients who received blood or its component from a donor with confirmed infection with SARS- CoV- 2 in the post-donation period [ 8 , 9 ]. Nevertheless, the theoretical risk of TTI and TTD associated with SARS-CoV-2 virus does exist and should not be underestimated [ [10] , [11] , [12] , [13] ].…”