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BACKGROUND 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 the SARS-CoV-2 shedding in excreta of COVID-19 patients. METHODS 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 RT-PCR. Viral shedding at multiple time points in specimens was recorded, and analyzed its correlation with clinical manifestations and the severity of illness. RESULTS A total of 42 laboratory-confirmed patients were enrolled, 8 (19.05%) of whom had gastrointestinal symptoms. 28 (66.67%) patients tested positive for SARS-CoV-2 RNA in stool specimens, which 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 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. The demographics, clinical characteristics, laboratory and radiologic findings did no differ between patients tested positive and negative for SARS-CoV-2 RNA in feces. Viral RNA was not detectable in urine specimens from 10 patients. CONCLUSIONS Our results demonstrated the presence of SARS-CoV-2 RNA in feces of COVID-19 patients, and suggested the possibility of SARS-CoV-2 transmission via the fecal-oral route. This article is protected by copyright. All rights reserved.
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