Excretion and viability of SARS-CoV-2 in feces and its association with the clinical outcome of COVID-19.
Excretion and viability of SARS-CoV-2 in feces and its association with the clinical outcome of COVID-19.
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DOI：
10.1038/s41598-022-11439-7
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发表时间：
2022-05-05
影响因子：
4.6
通讯作者：
中科院分区：
文献类型：
--
作者：
主要目的是评估粪便中排泄的SARS-CoV-2病毒颗粒的生存能力。此外，我们的目标是确定与粪便中SARS-CoV-2RNA检测相关的临床因素，并确定其存在是否与不利的临床结局相关，即重症监护病房(ICU)入院和/或死亡。一项前瞻性多中心队列研究，从2020年3月至2021年2月，对西班牙四家医院收治的经RT-PCR法确诊为SARS-CoV-2感染的新冠肺炎成年患者进行鼻咽拭子研究。62例成年新冠肺炎患者在入院时和/或随访期间采集了粪便样本，共79份粪便样本。62例患者中27例(43.5%)粪便标本中检出SARS-CoV-2RNA。复制病毒，通过在细胞培养中产生细胞病变效应和随后RT-PCR确认Ct值下降来衡量，在这些粪便样本中没有发现。粪便病毒排泄与胃肠道症状的存在或新冠肺炎患者进化的差异无关。我们的结果表明，SARS-CoV-2在粪便样本中的复制能力为零或非常有限，因此，SARS-CoV-2作为替代感染途径的粪便经口腔传播的可能性很小。在我们的研究中，在疾病开始时在粪便中检测SARS-CoV-2RNA与任何临床因素或不良临床结果无关。
The main objective was to evaluate the viability of the SARS-CoV-2 viral particles excreted in stools. In addition, we aimed to identify clinical factors associated with the detection of SARS-CoV-2 RNA in feces, and to determine if its presence is associated with an unfavorable clinical outcome, defined as intensive care unit (ICU) admission and/or death. A prospective multicenter cohort study of COVID-19 adult patients, with confirmed SARS-CoV-2 infection by RT-PCR assay in nasopharyngeal (NP) swabs admitted to four hospitals in Spain, from March 2020 to February 2021. Sixty-two adult COVID-19 patients had stool samples collected at admission and/or during the follow up, with a total of 79 stool samples. SARS-CoV-2 RNA was detected in stool samples from 27 (43.5%) out of the 62 patients. Replicative virus, measured by the generation of cytopathic effect in cell culture and subsequent RT-PCR confirmation of a decrease in the Ct values, was not found in any of these stool samples. Fecal virus excretion was not associated with the presence of gastrointestinal symptoms, or with differences in the evolution of COVID-19 patients. Our results suggest that SARS-CoV-2 replicative capacity is null or very limited in stool samples, and thus, the fecal–oral transmission of SARS-CoV-2 as an alternative infection route is highly unlikely. In our study, the detection of SARS-CoV-2 RNA in feces at the beginning of the disease is not associated with any clinical factor nor with an unfavorable clinical outcome.
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