Evidence for Gastrointestinal Infection of SARS-CoV-2

By Fei Xiao, Meiwen Tang, Xiaobin Zheng, Ye Liu, Xiaofeng Li, H. Shan. medRxiv, 2020

2,662 citations recorded by the source corpus.

The new coronavirus (SARS-CoV-2) outbreak originating from Wuhan, China, poses a threat to global health. While it's evident that the virus invades respiratory tract and transmits from human to human through airway, other viral tropisms and transmission routes remain unknown. We tested viral RNA in stool from 73 SARS-CoV-2-infected hospitalized patients using rRT-PCR. 53.42% of the patients tested positive in stool. 23.29% of the patients remained positive in feces even after the viral RNA decreased to undetectable level in respiratory tract. The viral RNA was also detected in gastrointestinal tissues. Furthermore, gastric, duodenal and rectal epithelia showed positive immunofluorescent staining of viral host receptor ACE2 and viral nucleocapsid protein in a case of SARS-CoV-2 infection. Our results provide evidence for gastrointestinal infection of SARS-CoV-2, highlighting its potential fecal-oral transmission route.

Subfields: Infectious Diseases

View Paper: https://www.semanticscholar.org/paper/40816ecc6a9df9c7bc7cc89db0781de85c6caf93

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Infectious Diseases

1. Kwok-Yung Yuen
2. Kwok-Hung Chan
3. Andrew G. Harrison
4. Tao Lin
5. Joachim L. Schultze
6. Penghua Wang

Citations in the corpus

• Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From a Hong Kong Cohort: Systematic Review and Meta-analysis (2020, positive): “Despite the inclusion of >60 reports, the actual prevalence of any gastrointestinal symptoms could be underestimated because many earlier studies did not report other gastrointestinal symptoms except for diarrhea.(19,24,34,35,40,42) Moreover, the majority of studies reported gastrointestinal symptom”
• SARS-CoV-2 RNA in wastewater anticipated COVID-19 occurrence in a low prevalence area (2020, positive): “In addition, gastric, duodenal, and rectal epithelial cells are infected by SARS-CoV-2 and the release of the infectious virions to the gastrointestinal tract supports the possible fecal-oral transmission route (Xiao et al., 2020).”
• Mechanisms of SARS-CoV-2 Transmission and Pathogenesis (2020, positive): “Finally, fecal–oral transmission has also been considered as a potential route of human spread, but remains an enigma despite evidence of RNA-laden aerosols being found nearby toilet bowls, along with detectable SARS-CoV-2 RNA in rectal swabs during the precursor epidemic of COVID-19 in China [41,59”
• SARS-CoV-2 in wastewater: State of the knowledge and research needs (2020, neutral): “Positive isolation from feces persisted in 23% of the patients even after it disappeared from the respiratory tract (Xiao et al., 2020).”
• Clinical Characteristics of COVID-19 Patients With Digestive Symptoms in Hubei, China: A Descriptive, Cross-Sectional, Multicenter Study (2020, background): “The intestinal flora plays a variety of important physiological roles in the body, such as affecting the body's nutritional metabolism, regulating the development and maturation of the body's immune system, and antibacterial effects [21].”
• The presence of SARS‐CoV‐2 RNA in the feces of COVID‐19 patients (2020, background): “7,16‐19 More strong evidence was revealed in that gastrointestinal tissue samples, obtained from a COVID‐19 patient using endoscopy, tested positive for SARS‐CoV‐2 RNA.(17) Furthermore, angiotensin‐converting enzyme 2 (ACE2), known as the cellular entry receptor of SARS‐ CoV‐2,(20) was abundantly ex”
• SARS-CoV-2 Receptor ACE2 Is an Interferon-Stimulated Gene in Human Airway Epithelial Cells and Is Detected in Specific Cell Subsets across Tissues (2020, positive): “Ileal Absorptive Enterocytes Express Host Factors Used by SARS-CoV-2 Next, we examined several other tissues for ACE2-expressing cells on the basis of the location of hallmark symptoms of COVID-19, focusing on the gastrointestinal tract due to reports of clinical symptoms and viral shedding (Xiao et”
• Artificial Intelligence and COVID-19: Deep Learning Approaches for Diagnosis and Treatment (2020, methodology): “Reference [68] studies the gastrointestinal infection caused by COVID-19.”