Rectally shed SARS-CoV-2 in COVID-19 inpatients is consistently lower than respiratory shedding and lacks infectivity

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Abstract

Objectives: Assessment 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. Methods: An 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. Results: SARS-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. Conclusions: Our data draw into question whether SARS-CoV-2 is transmitted readily from faeces.

Original languageEnglish
JournalClinical Microbiology and Infection
Volume28
Issue number2
Pages (from-to)304.e1-304.e3
ISSN1198-743X
DOIs
Publication statusPublished - Feb 2022

Keywords

  • Coronavirus disease 2019
  • Faeces
  • Gastrointestinal infection
  • Severe acute respiratory syndrome Coronavirus 2
  • Shedding
  • Transmission
  • Virus

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