SARS-CoV-2 RNA 存在于 COVID-19 患者的粪便中。

The presence of SARS-CoV-2 RNA in the feces of COVID-19 patients.

机构信息

Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.

Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.

出版信息

J Med Virol. 2020 Jul;92(7):833-840. doi: 10.1002/jmv.25825. Epub 2020 Apr 25.

Abstract

In December 2019, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China, and has spread globally. However, the transmission route of SARS-CoV-2 has not been fully understood. In this study, we aimed to investigate SARS-CoV-2 shedding in the excreta of COVID-19 patients. Electronical medical records, including demographics, clinical characteristics, laboratory and radiological findings of enrolled patients were extracted and analyzed. Pharyngeal swab, stool, and urine specimens were collected and tested for SARS-CoV-2 RNA by real-time reverse transcription polymerase chain reaction. Viral shedding at multiple time points in specimens was recorded, and its correlation analyzed with clinical manifestations and the severity of illness. A total of 42 laboratory-confirmed patients were enrolled, 8 (19.05%) of whom had gastrointestinal symptoms. A total of 28 (66.67%) patients tested positive for SARS-CoV-2 RNA in stool specimens, and this was not associated with the presence of gastrointestinal symptoms and the severity of illness. Among them, 18 (64.29%) patients remained positive for viral RNA in the feces after the pharyngeal swabs turned negative. The duration of viral shedding from the feces after negative conversion in pharyngeal swabs was 7 (6-10) days, regardless of COVID-19 severity. The demographics, clinical characteristics, laboratory and radiologic findings did not differ between patients who tested positive and negative for SARS-CoV-2 RNA in the feces. Viral RNA was not detectable in urine specimens from 10 patients. Our results demonstrated the presence of SARS-CoV-2 RNA in the feces of COVID-19 patients and suggested the possibility of SARS-CoV-2 transmission via the fecal-oral route.

摘要

2019 年 12 月,由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的 2019 冠状病毒病(COVID-19)在中国武汉出现,并已在全球传播。然而,SARS-CoV-2 的传播途径尚未完全了解。在本研究中,我们旨在研究 COVID-19 患者粪便中 SARS-CoV-2 的脱落情况。提取并分析了纳入患者的电子病历,包括人口统计学、临床特征、实验室和影像学检查结果。采集咽拭子、粪便和尿液标本,通过实时逆转录聚合酶链反应检测 SARS-CoV-2 RNA。记录了多个时间点标本中的病毒脱落情况,并分析其与临床表现和疾病严重程度的相关性。共纳入 42 例经实验室确诊的患者,其中 8 例(19.05%)有胃肠道症状。28 例(66.67%)患者的粪便标本中检测到 SARS-CoV-2 RNA 阳性,且这与胃肠道症状和疾病严重程度无关。其中,18 例(64.29%)患者在咽拭子转为阴性后粪便中仍持续检出病毒 RNA。咽拭子转为阴性后粪便中病毒脱落的持续时间为 7(6-10)天,与 COVID-19 的严重程度无关。粪便中 SARS-CoV-2 RNA 检测阳性和阴性的患者在人口统计学、临床特征、实验室和影像学检查结果方面无差异。10 例患者的尿液标本中未检测到病毒 RNA。我们的结果表明 COVID-19 患者粪便中存在 SARS-CoV-2 RNA,并提示 SARS-CoV-2 可能通过粪-口途径传播。

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