Excretion of SARS-CoV-2 through faecal specimens

Area of Science:

• Virology
• Public Health
• Infectious Diseases

Background:

• Coronavirus disease 2019 (COVID-19) is a global pandemic caused by SARS-CoV-2.
• Primary transmission routes include respiratory droplets and direct/indirect contact.
• The potential for fecal-oral transmission requires investigation.

Purpose of the Study:

• To investigate the presence and characteristics of SARS-CoV-2 in fecal specimens.
• To assess the potential for fecal-oral transmission of COVID-19.
• To inform disease control strategies.

Main Methods:

• Collection of 258 fecal specimens from nine Chinese provinces.
• Detection of SARS-CoV-2 RNA using real-time RT-PCR.
• Virus isolation in Vero cells and Spike gene sequencing.

Main Results:

• SARS-CoV-2 RNA detected in 36% (93/258) of stool samples.
• Higher positive rates in critical (54.4%) and severe (56.1%) patients.
• Live SARS-CoV-2 isolated from two severe patients; mutations identified in Spike gene.

Conclusions:

• Fecal shedding of SARS-CoV-2 is common, particularly in severe cases.
• Live virus in feces poses a contamination risk, suggesting fecal-oral transmission.
• Findings emphasize the need to consider fecal-oral transmission in COVID-19 control strategies, especially in resource-limited settings.