Severe Acute Respiratory Syndrome Coronavirus 2 Is Detected in the Gastrointestinal Tract of Asymptomatic Endoscopy Patients but Is Unlikely to Pose a Significant Risk to Healthcare Personnel.
Severe Acute Respiratory Syndrome Coronavirus 2 Is Detected in the Gastrointestinal Tract of Asymptomatic Endoscopy Patients but Is Unlikely to Pose a Significant Risk to Healthcare Personnel.
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DOI：
10.1016/j.gastha.2022.06.002
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Bimczok, Diane
中科院分区：
文献类型：
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作者：
Cherne, Michelle D;Gentry, Andrew B;Nemudraia, Anna;Nemudryi, Artem;Hedges, Jodi F;Walk, Heather;Blackwell, Karlin;Snyder, Deann T;Jerome, Maria;Madden, Wyatt;Hashimi, Marziah;Sebrell, T Andrew;King, David B;Plowright, Raina K;Jutila, Mark A;Wiedenheft, Blake;Bimczok, Diane
最近的证据表明，肠道是严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）感染的另一个目标。然而，SARS-CoV-2是否通过胃肠道分泌物传播仍不清楚。为了确定胃肠道SARS-CoV-2感染在无症状受试者中的流行程度，我们分析了内镜检查患者的胃肠道活检和液体样本中是否存在SARS-CoV-2。我们在一家地区医院进行了一项队列研究，招募了100名没有已知SARS-CoV-2感染的内镜患者（队列A）和12名先前诊断为COVID-19的患者（队列B）。采用聚合酶链式反应（PCR）、免疫组织化学和病毒分离技术对胃肠道活检和液体进行SARS-CoV-2筛查，并分析体外胃肠道液体中SARS-CoV-2的稳定性。在队列a中，1/100例患者的结肠组织中检测到SARS-CoV-2核糖核酸。在队列B中，3例结肠液体样本经PCR检测为SARS-CoV-2阳性，在各自活检样本的上皮中检测到病毒核衣壳蛋白。然而，没有从任何样本中回收感染性病毒粒子。体外将SARS-CoV-2暴露于结肠液体中，1小时内传染性SARS-CoV-2降低4倍（P≤0.05）。总体而言，在COVID-19分解后，内窥镜样本中持续检测到SARS-CoV-2，这表明肠道是SARS-CoV-2的长期储存库。由于没有传染性病毒粒子被恢复，并且在存在结肠液体的情况下SARS-CoV-2被迅速灭活，因此，由于未确诊的无症状或持续的胃肠道SARS-CoV-2感染，进行内窥镜手术不太可能与重大感染风险相关。
Recent evidence suggests that the gut is an additional target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, whether SARS-CoV-2 spreads via gastrointestinal secretions remains unclear. To determine the prevalence of gastrointestinal SARS-CoV-2 infection in asymptomatic subjects, we analyzed gastrointestinal biopsy and liquid samples from endoscopy patients for the presence of SARS-CoV-2. We enrolled 100 endoscopic patients without known SARS-CoV-2 infection (cohort A) and 12 patients with a previous COVID-19 diagnosis (cohort B) in a cohort study performed at a regional hospital. Gastrointestinal biopsies and fluids were screened for SARS-CoV-2 by polymerase chain reaction (PCR), immunohistochemistry, and virus isolation assay, and the stability of SARS-CoV-2 in gastrointestinal liquids in vitro was analyzed. SARS-CoV-2 ribonucleic acid was detected by PCR in the colonic tissue of 1/100 patients in cohort A. In cohort B, 3 colonic liquid samples tested positive for SARS-CoV-2 by PCR and viral nucleocapsid protein was detected in the epithelium of the respective biopsy samples. However, no infectious virions were recovered from any samples. In vitro exposure of SARS-CoV-2 to colonic liquid led to a 4-log–fold reduction of infectious SARS-CoV-2 within 1 hour (P ≤ .05). Overall, the persistent detection of SARS-CoV-2 in endoscopy samples after resolution of COVID-19 points to the gut as a long-term reservoir for SARS-CoV-2. Since no infectious virions were recovered and SARS-CoV-2 was rapidly inactivated in the presence of colon liquids, it is unlikely that performing endoscopic procedures is associated with a significant infection risk due to undiagnosed asymptomatic or persistent gastrointestinal SARS-CoV-2 infections.