SARS-CoV-2 detected in respiratory, fecal, and serum specimens
1. A small number of individuals with confirmed COVID-19 were found to have viral RNA in their feces (29%) and blood (1%). No individuals had detectable viral RNA in their urine.
2. Bronchoalveolar, sputum, and nasopharyngeal specimens were positive for viral RNA in the majority of samples from patients with COVID-19.
Evidence Rating: 2 (Good)
Study Rundown: Real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) of nasopharyngeal swabs has typically been used to confirm infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19. However, it remains unclear whether the virus can be detected and potentially transmitted via other mediums. To examine this, rRT-PCR was performed on blood, urine, oral, nasal and sputum samples from 205 SARS-Cov-2 positive patients from three hospitals in China. Nearly all patients had detectable viral load in lower respiratory tract samples. Close to one-third of patients also had detectable viral RNA in their fecal matter. Additionally, a small percentage of blood samples were positive for the virus. No individuals had detectable viral RNA in their urine. These results indicate that SARS-Cov-2 (COVID 19) may be transmissible via the fecal-oral route, in addition to the previously known respiratory droplet route, a finding that has major public health implications. This study was limited by a small sample size, limited geographic and racial diversity of subjects, and failure to collect the same samples across all patients.
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