The presence of SARS‐CoV‐2 RNA in the feces of COVID‐19 patients. Issue 7 (25th April 2020)

• Record Type: Journal Article
• Authors: Chen, Yifei; Chen, Liangjun; Deng, Qiaoling; Zhang, Guqin; Wu, Kaisong; Ni, Lan; Yang, Yibin; Liu, Bing; Wang, Wei; Wei, Chaojie; Yang, Jiong; Ye, Guangming; Cheng, Zhenshun
• Other Names: Luo Guangxiang (George) guestEditor.; Gao Shou‐Jiang guestEditor.
• Is Part Of: Journal of medical virology. Volume 92:Issue 7(2020)
• Page Start: 833
• Page End: 840
• Publication Date: 2020-04-25
• Subjects: coronavirus disease 2019 -- fecal‐oral transmission -- severe acute respiratory syndrome coronavirus 2 -- viral RNA -- viral shedding; Virology -- Periodicals; 616
• DOI: 10.1002/jmv.25825
• Languages: English
• ISSNs: 0146-6615

Abstract

Abstract: In December 2019, coronavirus disease 2019 (COVID‐19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), emerged in Wuhan, China, and has spread globally. However, the transmission route of SARS‐CoV‐2 has not been fully understood. In this study, we aimed to investigate SARS‐CoV‐2 shedding in the excreta of COVID‐19 patients. Electronical medical records, including demographics, clinical characteristics, laboratory and radiological findings of enrolled patients were extracted and analyzed. Pharyngeal swab, stool, and urine specimens were collected and tested for SARS‐CoV‐2 RNA by real‐time reverse transcription polymerase chain reaction. Viral shedding at multiple time points in specimens was recorded, and its correlation analyzed with clinical manifestations and the severity of illness. A total of 42 laboratory‐confirmed patients were enrolled, 8 (19.05%) of whom had gastrointestinal symptoms. A total of 28 (66.67%) patients tested positive for SARS‐CoV‐2 RNA in stool specimens, and this was not associated with the presence of gastrointestinal symptoms and the severity of illness. Among them, 18 (64.29%) patients remained positive for viral RNA in the feces after the pharyngeal swabs turned negative. The duration of viral shedding from the feces after negative conversion in pharyngeal swabs was 7 (6‐10) days, regardless of COVID‐19 severity. The demographics, clinical characteristics, laboratory and radiologic findings did not differ between patients who tested positive and negative for SARS‐CoV‐2 RNA in the feces. Viral RNA was not detectable in urine specimens from 10 patients. Our results demonstrated the presence of SARS‐CoV‐2 RNA in the feces of COVID‐19 patients and suggested the possibility of SARS‐CoV‐2 transmission via the fecal‐oral route. Research Highlights: Two thirds of COVID‐19 patients tested positive for SARS‐CoV‐2 RNA in stool specimens. The presence of SARS‐CoV‐2 RNA in the feces of COVID‐19 patients was not associated with gastrointestinal symptoms and the severity of illness. More than 60% patients remained positive for viral RNA in feces after pharyngeal swabs turned negative. The duration of viral shedding from feces after negative conversion in pharyngeal swabs was 7 (6‐10) days, regardless of COVID‐19 severity. Fecal‐oral route may serve as an alternative transmission route for SARS‐CoV‐2.