Abstract
ObjectivesAssessment of whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been propagated during intestinal passage and infectivity is conserved when shed rectally by hospitalized individuals. MethodsAn exploratory cohort study including 28 inpatients with coronavirus disease 2019 with estimation of RNA levels by RT-PCR and of viral infectivity by culturing of viral material sampled concomitantly and identically from pharynx and rectum. ResultsSARS-CoV-2 RNA was detected more frequently (91%, 30/33 versus 42%, 14/33, p <0.0001) and at higher concentrations (median levels 2 190 186 IU/mL versus 13 014 IU/mL, p <0.0001) in the pharyngeal swabs than in the rectal swabs. For all sample pairs (n = 33) the rectal swabs contained undetectable or lower SARS-CoV-2 RNA concentrations than their paired pharyngeal swabs. Replicative virus was found in 37% (11/30) of the PCR-positive pharyngeal swabs, whereas none of the PCR-positive rectal swabs could be cultured (0%, 0/14) despite containing SARS-CoV-2 RNA concentrations up to 1 544 691 IU/mL. ConclusionsOur data draw into question whether SARS-CoV-2 is transmitted readily from faeces.
Highlights
The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in stool was reported early in the coronavirus disease 2019 (COVID-19) pandemic [1] and several studies have since confirmed rectal shedding of SARS-CoV-2 RNA [2]
Rectal shedding may persist for several weeks, and in some patients even surpass the period when viral RNA is detectable in respiratory samples [3,4]
The concentration of SARS-CoV-2 RNA in the rectal swabs was lower than the concentration in the corresponding pharyngeal swab with a median difference of 1 711 376 IU/mL (IQR 217 724e12 434 855 IU/ mL) (p
Summary
The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in stool was reported early in the coronavirus disease 2019 (COVID-19) pandemic [1] and several studies have since confirmed rectal shedding of SARS-CoV-2 RNA [2]. Rectal shedding may persist for several weeks, and in some patients even surpass the period when viral RNA is detectable in respiratory samples [3,4]. These findings have led to the suggestion that SARSCoV-2 is capable of being spread from faeces by surviving and/or propagating during its passage though the gastrointestinal tract [2,5]. The existence of such a transmission route requires that SARS-. Pedersen et al / Clinical Microbiology and Infection xxx (xxxx) xxx oropharynx of individuals with COVID-19 to assess whether rectally shed SARS-CoV-2 has propagated during gastrointestinal passage and preserved its infectious potential
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