1. Excretion and viability of SARS-CoV-2 in feces and its association with the clinical outcome of COVID-19
- Author
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Cristina Cerrada-Romero, Judith Berastegui-Cabrera, Pedro Camacho-Martínez, Josune Goikoetxea-Aguirre, Patricia Pérez-Palacios, Sonia Santibáñez, María José Blanco-Vidal, Adoración Valiente, Jorge Alba, Regino Rodríguez-Álvarez, Álvaro Pascual, José Antonio Oteo, José Miguel Cisneros, Jerónimo Pachón, Inmaculada Casas-Flecha, Elisa Cordero, Francisco Pozo, Javier Sánchez-Céspedes, Instituto de Salud Carlos III, Ministerio de Economía, Industria y Competitividad (España), European Regional Development Fund, Ministerio de Ciencia e Innovación (España), Gobierno de Andalucía, Plan Nacional de I+D+i (España), Red de Investigación Cooperativa en Investigación en Patología Infecciosa, European Commission, Junta de Andalucía, Ministerio de Economía y Competitividad (España), and Ministerio de Ciencia, Innovación y Universidades (España)
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Adult ,Cohort Studies ,Feces ,Multidisciplinary ,SARS-CoV-2 ,viruses ,COVID-19 ,Humans ,RNA, Viral ,Prospective Studies - Abstract
The main objective was to evaluate the viability of the SARS-CoV-2 viral particles excreted in stools. In addition, we aimed to identify clinical factors associated with the detection of SARS-CoV-2 RNA in feces, and to determine if its presence is associated with an unfavorable clinical outcome, defined as intensive care unit (ICU) admission and/or death. A prospective multicenter cohort study of COVID-19 adult patients, with confirmed SARS-CoV-2 infection by RT-PCR assay in nasopharyngeal (NP) swabs admitted to four hospitals in Spain, from March 2020 to February 2021. Sixty-two adult COVID-19 patients had stool samples collected at admission and/or during the follow up, with a total of 79 stool samples. SARS-CoV-2 RNA was detected in stool samples from 27 (43.5%) out of the 62 patients. Replicative virus, measured by the generation of cytopathic effect in cell culture and subsequent RT-PCR confirmation of a decrease in the Ct values, was not found in any of these stool samples. Fecal virus excretion was not associated with the presence of gastrointestinal symptoms, or with differences in the evolution of COVID-19 patients. Our results suggest that SARS-CoV-2 replicative capacity is null or very limited in stool samples, and thus, the fecal–oral transmission of SARS-CoV-2 as an alternative infection route is highly unlikely. In our study, the detection of SARS-CoV-2 RNA in feces at the beginning of the disease is not associated with any clinical factor nor with an unfavorable clinical outcome., This work was supported by National Plan R+D+I 2013–2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministry of Economy, Industry, and Competitiveness, Spanish Network for Research in Infectious Diseases [REIPI RD16/0016/0009]; cofinanced by European Development Regional Fund “A way to achieve Europe”, Operative program Intelligent Growth 2014–2020; and supported by Grants from the Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Proyectos de Investigación sobre el SARS-CoV-2 y la enfermedad COVID-19 [COV20/00370; COV20/00580]. J.S.C. is a researcher belonging to the program “Nicolás Monardes” (C-0059-2018), Servicio Andaluz de Salud, Junta de Andalucía, Spain.
- Published
- 2022
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