Detection of SARS-CoV-2 RNA presence in colorectal mucus collected from patients recovering from COVID-19 for assessing the risk of exposure to the virus in medical professionals performing invasive colorectal procedures including endoscopy.

2019冠状病毒病大流行不仅影响到数百万人，也给照顾患者的医疗专业人员带来了很高的风险。现已确定，该病毒主要引起呼吸道症状，通常以严重肺炎的发展为高潮，COVID-19主要通过感染者咳嗽或打喷嚏时产生的气溶胶飞沫传播。然而，很明显，COVID-19也可以侵入胃肠道，并且不仅在疾病活动性期间，而且在症状消失时，患者的粪便样本中也存在该病毒，并且咽涂片中不再检测到该病毒。该病毒也可在无症状携带者的粪便中发现。这意味着该病毒通常存在于人体肠道中，并可能在胃肠道诊断或手术过程中感染医疗专业人员，例如常用的内窥镜检查和结直肠手术。因此，除了挽救生命的紧急干预措施外，所有这些程序目前在英国都暂停了。为保护胃肠病学和结直肠外科医务人员的健康，迫切需要可靠的检测新冠肺炎在人体肠道中的存在的方法。虽然可以进行粪便检测以检测COVID-19，但如果需要反复收集粪便，可能会令人不愉快，尤其不方便。此外，该病毒的最高浓度预计将出现在结肠直肠粘液（CM）中，这是人类粪便中信息量最大的成分。诊断有限公司最近开发了一种对患者友好的非侵入性CM样本采集（自我采集）方法，可以在同一受试者中重复应用。利用这种新方法收集的样品具有非常丰富的生物标志物，适用于检测炎症性肠病和结直肠癌等主要结直肠疾病。虽然我们相信CM样品也提供了一种很好的生物材料来检测肠道中的感染性病原体，但到目前为止，对这一方向的探索仅被视为一种潜在的未来选择。当前的COVID-19大流行使情况发生了巨大变化，使其成为一项紧迫的任务。拟议的试点研究将由diagnostics Ltd与圣乔治医院和伦敦圣乔治大学合作进行，主要目的是证明在感染后恢复期间定量评估CM中COVID-19存在的可行性，从而为参与胃肠道手术的医疗专业人员提供估计暴露风险的工具。关于病毒行为的新宝贵信息的积累（包括我们的早期结果）使我们认识到，该项目将提供一系列重要的额外成果，这些成果的潜在利用不可能纳入原计划项目的严格时间框架。项目扩展可以帮助探索与项目的科学和商业方面相关的一些结果。

The COVID-19 pandemic not only affects millions of people, but also generates high levels of risk for medical professionals caring for their patients. It is established that the virus induces predominantly respiratory symptoms that are often culminated by the development of severe pneumonias, and COVID-19 mostly spreads through aerosol droplets generated when an infected individual coughs or sneezes. It is, however, evident that COVID-19 can also invade gastrointestinal tract, and the presence of the virus was shown in stool samples from patients not only during active disease, but also when its symptoms disappear, and the virus is no longer detectable in pharyngeal smears. The virus can also be found in the faeces of asymptomatic carriers. This means that the virus is often present in the human gut and may infect medical professionals during diagnostic or surgical procedures on gastrointestinal tract, such as commonly applied endoscopic investigations and colorectal surgery. Therefore, all these procedures apart from life-saving urgent interventions are currently suspended in the UK. Reliable tests for detecting the presence of COVID-19 in the human gut are urgently needed for protecting health of medical personnel working in gastroenterology and colorectal surgery.Although stool testing for COVID-19 detection is possible, stool collection may be unpleasant and especially inconvenient if needed repeatedly. Moreover, the highest concentrations of the virus are expected to be present in the colorectal mucus (CM), the most informative element of the human faeces.DiagNodus Ltd has recently developed a patient-friendly non-invasive method for CM sample collection (self-collection) that can be repeatedly applied in the same subject. Samples collected using this new method are very rich in biomarkers and suitable for detecting such major colorectal conditions as inflammatory bowel disease and colorectal cancer. Although we believe that CM samples also presents an excellent biological material for detecting infectious agents in the gut, the exploration of this direction was so far regarded only as a potential future option. The current COVID-19 pandemics has dramatically changed the situation, making it an urgent task. The main objective of the proposed pilot study, which will be undertaken by DiagNodus Ltd in collaboration with St George's Hospital and St George's University of London, is to prove the feasibility of quantitatively evaluating the presence of COVID-19 in CM during recovery after the infection, thus providing a tool for estimating the risk of exposure for medical professionals involved in gastrointestinal procedures.Accumulation of new valuable information on the behaviour of the virus (including our early results) has led us to realising that the project will provide a range of important additional outcomes, potential exploitation of which is impossible to incorporate into the strict time frame of the originally planned project. Project extension can help exploring some of these outcomes related to both scientific and commercial aspects of the project.