Rezzoug Inès, Visseaux Benoit, Bertine Mélanie, Parisey Marion, Bonnal Christine, Ruppe Etienne, Descamps Diane, Timsit Jean François, Yazdanpanah Yazdan, Armand-Lefevre Laurence, Houze Sandrine, Argy Nicolas
Laboratoire de Parasitologie-Mycologie, Hôpital Bichat-Claude Bernard, Assistance Publique des Hôpitaux de Paris, 75018 Paris, France.
Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Assistance Publique des Hôpitaux de Paris, 75018 Paris, France.
Microorganisms. 2023 Jul 9;11(7):1780. doi: 10.3390/microorganisms11071780.
The physiopathological mechanisms responsible for digestive symptoms in COVID-19 patients are still unclear. The aim of this study was to determine the influence of faecal viral shedding on digestive symptoms and propose differential diagnoses in order to understand the gastrointestinal clinical spectrum in acute cases of COVID-19. All patients managed between March and May 2020, from whom stool samples were collected for microbiological investigations, were included. Microbiological analysis consisted of syndromic PCR screening and microscopic parasitological examination supplemented with microsporidia and multiplex protozoa PCR. SARS-CoV-2 infection was diagnosed via viral detection in respiratory and frozen stool samples, completed via serological test when necessary. Epidemiological, clinical, radiological, and biological data and clinical courses were compared according to COVID-19 status and faecal SARS-CoV-2 shedding and enteric co-infection status. The sample included 50 COVID+ and 67 COVID- patients. Faecal viral shedding was detected in 50% of stool samples and was associated with a higher viral load in the upper respiratory tract. Detected enteric pathogens were not different between subjects with different COVID-19 statuses or faecal SARS-CoV-2 shedding and had no impact on the clinical course for COVID-19 patients. The connection between SARS-CoV-2 shedding and enteric pathogen co-infection involvement in gastrointestinal presentation and clinical course is still unclear, suggesting other processes are involved in digestive disorders in COVID-19 patients.
新冠病毒肺炎（COVID-19）患者消化系统症状的病理生理机制仍不清楚。本研究旨在确定粪便病毒 shedding 对消化系统症状的影响，并提出鉴别诊断，以了解 COVID-19 急性病例的胃肠道临床谱。纳入了 2020 年 3 月至 5 月间接受治疗且采集了粪便样本进行微生物学检查的所有患者。微生物学分析包括症状性 PCR 筛查和显微镜寄生虫学检查，并辅以微孢子虫和多重原生动物 PCR。通过呼吸道和冷冻粪便样本中的病毒检测诊断 SARS-CoV-2 感染，必要时通过血清学检测完成。根据 COVID-19 状态、粪便 SARS-CoV-2 shedding 和肠道合并感染状态比较流行病学、临床、放射学和生物学数据及临床病程。样本包括 50 例 COVID+患者和 67 例 COVID-患者。50%的粪便样本检测到粪便病毒 shedding，且与上呼吸道较高的病毒载量相关。不同 COVID-19 状态或粪便 SARS-CoV-2 shedding 的受试者中检测到的肠道病原体无差异，对 COVID-19 患者的临床病程也无影响。SARS-CoV-2 shedding 与肠道病原体合并感染在胃肠道表现和临床病程中的关联仍不清楚，提示 COVID-19 患者消化系统紊乱涉及其他过程。 （注：文中“shedding”可能是指病毒脱落等相关意思，具体准确含义需结合专业背景进一步理解）
