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. 2020 Jul;92(7):833-840.
doi: 10.1002/jmv.25825. Epub 2020 Apr 25.

The presence of SARS-CoV-2 RNA in the feces of COVID-19 patients

Yifei Chen  1 , Liangjun Chen  2 , Qiaoling Deng  2 , Guqin Zhang  1 , Kaisong Wu  1 , Lan Ni  1 , Yibin Yang  1 , Bing Liu  1 , Wei Wang  1 , Chaojie Wei  1 , Jiong Yang  1 , Guangming Ye  2 , Zhenshun Cheng  1
Affiliations

The presence of SARS-CoV-2 RNA in the feces of COVID-19 patients

Yifei Chen et al. J Med Virol. 2020 Jul.

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.

Keywords: coronavirus disease 2019; fecal-oral transmission; severe acute respiratory syndrome coronavirus 2; viral RNA; viral shedding.

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