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. 2005 Mar;24(3):165-71.
doi: 10.1007/s10096-005-1299-5.

Persistent shedding of viable SARS-CoV in urine and stool of SARS patients during the convalescent phase

D Xu  1 , Z Zhang, L Jin, F Chu, Y Mao, H Wang, M Liu, M Wang, L Zhang, G F Gao, F S Wang
Affiliations

Persistent shedding of viable SARS-CoV in urine and stool of SARS patients during the convalescent phase

D Xu et al. Eur J Clin Microbiol Infect Dis. 2005 Mar.

Abstract

In order to further the present knowledge of the emerging severe acute respiratory syndrome-associated coronavirus (SARS-CoV), 486 different specimens from 54 patients with a clinical diagnosis of SARS were investigated for the presence of viral RNA, and 314 plasma specimens of 73 patients were examined for IgM and IgG antibodies specific against SARS-CoV using an indirect ELISA. Viral RNA was detectable in 28 of the 54 patients tested. Cumulative data showed that 67 of the 73 SARS patients demonstrated seroconversion by week 5 of illness. In contrast, only 1 of 278 healthy subjects enrolled in the study was found to be positive for the IgG antibody. Coexistence of viral RNA in plasma and specific antibodies was simultaneously observed over three consecutive weeks in two critical cases. In three convalescent patients in particular, cultivable SARS-CoV was detected in stool or urine specimens for longer than 4 weeks (29-36 days). These findings suggest that SARS-CoV may remain viable in the excretions of convalescent patients.

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Figures

Fig. 1
Fig. 1
Electrophoretic analysis of RT-PCR products for SARS-CoV RNA amplified from clinical specimens. Lanes1−6 were loaded with RT-PCR products; laneM was loaded with 100 bp DNA marker; 109bp and 156bp-long bands correspond to the amplified R (ORF 1b) and N gene fragments of SARS-CoV, respectively
Fig. 2
Fig. 2
Percent of positive results for SARS-CoV RNA detected by RT-PCR in different clinical specimens of 54 patients with a clinical diagnosis of SARS. Combined represents the percentage of all patients from whom any of the specimens was positive for SARS-CoV RNA. n represents the number of patients in whom SARS-CoV was detected
Fig. 3
Fig. 3
Cumulative percentage of seroconversion among 73 patients with a clinical diagnosis of SARS. Combined represents the cumulative percentage of patients demonstrating IgM and/or IgG seroconversion
Fig. 4
Fig. 4
Observation of cytopathic effect (CPE) and SARS-CoV particles in Vero E6 cells infected with SARS-CoV isolated from the stool sample of a convalescent-phase patient with SARS. a–b Light microscopy images of Vero E6 cells without/with CPE. c Electron microscopy image of Vero E6 cells with CPE showing the SARS-CoV particles
See this image and copyright information in PMC

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