Abstract
The global outbreak of SARS-CoV-2 spread rapidly throughout the world which transmitted among humans through various routes. Asymptomatic (carriers) and possible fecal-oral transmission, resulted into a large-scale spread. These issues pose great challenges to disease diagnosis and epidemic control. We obtained data on 29 cases of COVID-19 patients in Jinan, China, and reported the clinical data of asymptomatic patients confirmed with stool samples positive. Some patients with gastrointestinal infections are secondary to pulmonary infections, and during the patients' recovery period, the virus may still existin the patient's gastrointestinal tract over 7 days. We combined with epidemiological and clinical data of asymptomatic patients to analyze the possible routes of viral transmission and infection, including eyes-nose, hands-eyes, fecal-oral, and eyes-oral, et al., thus first presented the two-way transmission through eyes-oral. Through associating infection symptoms with the transmission routes of virus and the patient course of the disease, we expect to provide guidelines for clinical diagnosis and the basis for suppressing the spread of the virus and antiviral treatment.
Highlights
In late December 2019, the global outbreak of a novel coronavirus (2019-nCoV) spread rapidly throughout the world resulting in more than 5,404,512 cases and 343,514 deaths till May 26th, 2020 (WHO, 2020)
It is suggested that study on the transmission routes of the virus is a feasible pathway in controlling the disease effectively and we summarize the transmission routes of SARS-CoV-2 systematically
W. et al, 2020; Wang W. et al, 2020). These results showed that a few new cases of COVID-19 began with conjunctivitis as the first symptom, and the SARS-CoV-2 containing in the eye surface may enter into the nasal cavity and throat through drain tears
Summary
In late December 2019, the global outbreak of a novel coronavirus (2019-nCoV) spread rapidly throughout the world resulting in more than 5,404,512 cases and 343,514 deaths till May 26th, 2020 (WHO, 2020). We systematically investigated the clinical and laboratory characteristics of confirmed 29 cases provided by Jinan infectious disease hospital, Shandong University, and the environmental samples collected from Jinan central hospital, Shandong University. Summarizing the published articles, including SARS-CoV and SARS-CoV-2, we combined with epidemiological and clinical data to analyze the possible routes of asymptomatic patients with virus infection in order to provide the basis for suppressing the spread of the virus, and antiviral treatment and advice for the protection of medical staff. We collected throat swabs and blood samples and other environmental samples, including the four patients’ conjunctival secretions, feces, cell phone surfaces, hands surfaces, an inner surface of the mask, ground, door handles surface, the head surface of bed, et al in the isolation ward before they were transferred to Jinan infectious disease hospital.
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