1. Investigation of SARS-CoV-2 faecal shedding in the community: a prospective household cohort study (COVID-LIV) in the UK.
- Author
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Vaselli, Natasha Marcella, Setiabudi, Wega, Subramaniam, Krishanthi, Adams, Emily R., Turtle, Lance, Iturriza-Gómara, Miren, Solomon, Tom, Cunliffe, Nigel A., French, Neil, Hungerford, Daniel, on behalf of the COVID-LIV Study Group, Vivancos, Roberto, Gabbay, Mark, Buchan, Iain, Carrol, Enitan D., Gamble, Carrol, Crossley, Lynnette, Joseph, Neil, Wilton, Moon, and Troughton, Lee D.
- Subjects
SARS-CoV-2 ,COVID-19 ,INFECTIOUS disease transmission ,COHORT analysis ,HOUSEHOLDS - Abstract
Background: SARS-CoV-2 is frequently shed in the stool of patients hospitalised with COVID-19. The extent of faecal shedding of SARS-CoV-2 among individuals in the community, and its potential to contribute to spread of disease, is unknown.Methods: In this prospective, observational cohort study among households in Liverpool, UK, participants underwent weekly nasal/throat swabbing to detect SARS-CoV-2 virus, over a 12-week period from enrolment starting July 2020. Participants that tested positive for SARS-CoV-2 were asked to provide a stool sample three and 14 days later. In addition, in October and November 2020, during a period of high community transmission, stool sampling was undertaken to determine the prevalence of SARS-CoV-2 faecal shedding among all study participants. SARS-CoV-2 RNA was detected using Real-Time PCR.Results: A total of 434 participants from 176 households were enrolled. Eighteen participants (4.2%: 95% confidence interval [CI] 2.5-6.5%) tested positive for SARS-CoV-2 virus on nasal/throat swabs and of these, 3/17 (18%: 95% CI 4-43%) had SARS-CoV-2 detected in stool. Two of three participants demonstrated ongoing faecal shedding of SARS-CoV-2, without gastrointestinal symptoms, after testing negative for SARS-CoV-2 in respiratory samples. Among 165/434 participants without SARS-CoV-2 infection and who took part in the prevalence study, none had SARS-CoV-2 in stool. There was no demonstrable household transmission of SARS-CoV-2 among households containing a participant with faecal shedding.Conclusions: Faecal shedding of SARS-CoV-2 occurred among community participants with confirmed SARS-CoV-2 infection. However, during a period of high community transmission, faecal shedding of SARS-CoV-2 was not detected among participants without SARS-CoV-2 infection. It is unlikely that the faecal-oral route plays a significant role in household and community transmission of SARS-CoV-2. [ABSTRACT FROM AUTHOR]- Published
- 2021
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