Investigation of SARS-CoV-2 faecal shedding in the community: a prospective household cohort study (COVID-LIV) in the UK.
Investigation of SARS-CoV-2 faecal shedding in the community: a prospective household cohort study (COVID-LIV) in the UK.
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DOI：
10.1186/s12879-021-06443-7
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发表时间：
2021-08-09
影响因子：
3.7
通讯作者：
COVID-LIV Study Group
中科院分区：
文献类型：
--
作者：
Vaselli NM;Setiabudi W;Subramaniam K;Adams ER;Turtle L;Iturriza-Gómara M;Solomon T;Cunliffe NA;French N;Hungerford D;COVID-LIV Study Group
SARS-CoV-2经常在因COVID-19住院的患者的粪便中脱落。目前尚不清楚SARS-CoV-2在社区个体中粪便脱落的程度及其促进疾病传播的潜力。在这项针对英国利物浦家庭的前瞻性、观察性队列研究中，参与者从2020年7月开始入组，在12周内每周接受鼻/喉拭子检测SARS-CoV-2病毒。SARS-CoV-2检测呈阳性的参与者被要求在3天和14天后提供粪便样本。此外，在2020年10月和11月，在社区传播高发期，进行了粪便采样，以确定所有研究参与者中SARS-CoV-2粪便脱落的患病率。采用实时荧光定量PCR检测SARS冠状病毒2型RNA。共有来自176个家庭的434名参与者参加。18名参与者（4.2%：95%置信区间[CI] 2.5-6.5%）的鼻/咽拭子检测结果为SARS-CoV-2病毒阳性，其中3/17名参与者（18%：95% CI 4-43%）在粪便中检测到SARS-CoV-2。三名参与者中有两名在呼吸道样本中检测出SARS-CoV-2阴性后，表现出持续的SARS-CoV-2粪便脱落，没有胃肠道症状。在没有SARS-CoV-2感染并参加流行率研究的165/434名参与者中，没有人在粪便中发现SARS-CoV-2。在包含粪便脱落参与者的家庭中，没有可证实的SARS-CoV-2家庭传播。在确认感染SARS-CoV-2的社区参与者中发生了SARS-CoV-2的粪便脱落。然而，在高社区传播期间，在没有SARS-CoV-2感染的参与者中没有检测到SARS-CoV-2的粪便脱落。粪-口途径不太可能在SARS-CoV-2的家庭和社区传播中发挥重要作用。在线版本包含补充材料，可通过10.1186/s12879-021-06443-7获取。
SARS-CoV-2 is frequently shed in the stool of patients hospitalised with COVID-19. The extent of faecal shedding of SARS-CoV-2 among individuals in the community, and its potential to contribute to spread of disease, is unknown. In this prospective, observational cohort study among households in Liverpool, UK, participants underwent weekly nasal/throat swabbing to detect SARS-CoV-2 virus, over a 12-week period from enrolment starting July 2020. Participants that tested positive for SARS-CoV-2 were asked to provide a stool sample three and 14 days later. In addition, in October and November 2020, during a period of high community transmission, stool sampling was undertaken to determine the prevalence of SARS-CoV-2 faecal shedding among all study participants. SARS-CoV-2 RNA was detected using Real-Time PCR. A total of 434 participants from 176 households were enrolled. Eighteen participants (4.2%: 95% confidence interval [CI] 2.5–6.5%) tested positive for SARS-CoV-2 virus on nasal/throat swabs and of these, 3/17 (18%: 95% CI 4–43%) had SARS-CoV-2 detected in stool. Two of three participants demonstrated ongoing faecal shedding of SARS-CoV-2, without gastrointestinal symptoms, after testing negative for SARS-CoV-2 in respiratory samples. Among 165/434 participants without SARS-CoV-2 infection and who took part in the prevalence study, none had SARS-CoV-2 in stool. There was no demonstrable household transmission of SARS-CoV-2 among households containing a participant with faecal shedding. Faecal shedding of SARS-CoV-2 occurred among community participants with confirmed SARS-CoV-2 infection. However, during a period of high community transmission, faecal shedding of SARS-CoV-2 was not detected among participants without SARS-CoV-2 infection. It is unlikely that the faecal-oral route plays a significant role in household and community transmission of SARS-CoV-2. The online version contains supplementary material available at 10.1186/s12879-021-06443-7.
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