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Observational Study
. 2025 May 29;20(5):e0322543.
doi: 10.1371/journal.pone.0322543. eCollection 2025.

The added diagnostic value of RT-PCR on faeces for the diagnosis of COVID-19

Nathalie Van der Moeren  1   2   3 , Rik van den Biggelaar  1   2   3 , Karin B Gast  4 , Jaco J Verweij  1   2   3 , Barbara J M Bergmans  5 , Joep J J M Stohr  1   2   3 , Jean-Luc Murk  1   2   3
Affiliations
Observational Study

The added diagnostic value of RT-PCR on faeces for the diagnosis of COVID-19

Nathalie Van der Moeren et al. PLoS One. .

Abstract

Objectives: To determine whether combining a SARS-CoV-2 RT-PCR on a fecal sample [FS] with a RT-PCR on an upper respiratory tract sample [URTS] results in additional COVID-19 diagnoses.

Methods: We conducted a retrospective observational study at a regional hospital in The Netherlands from 27 February 2020-30 June 2020. Patients presenting with COVID-19-like symptoms for who a SARS-CoV-2 RT-PCR on both URTS and FS were obtained within 24 hours were included. We calculated the difference in positive RT-PCR when combining URTS/FS compared to URTS alone, overall and stratified by symptom duration and disease severity.

Results: Three hundred eighty-six patients were included of which 63 had a positive RT-PCR on URTS [n = 8], FS [n = 19] or both [n = 36], corresponding to a prevalence of 16.3%. The addition of testing FS increased the number of COVID-19 diagnoses by 31.8% [95%CI 20,3%-43,2%].

Conclusions: We showed that adding SARS-CoV-2 RT-PCR on FS to URTS yields significantly more COVID-19 diagnoses. The inclusion of an FS may therefore be considered in patients with a negative URTS and high suspicion of COVID-19.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Overview of included individuals, disease severity and time since symptom onset.
See this image and copyright information in PMC

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