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Gastrointestinal symptoms and fecal shedding of SARS-CoV-2 RNA suggest prolonged gastrointestinal infection.
Natarajan, Aravind; Zlitni, Soumaya; Brooks, Erin F; Vance, Summer E; Dahlen, Alex; Hedlin, Haley; Park, Ryan M; Han, Alvin; Schmidtke, Danica T; Verma, Renu; Jacobson, Karen B; Parsonnet, Julie; Bonilla, Hector F; Singh, Upinder; Pinsky, Benjamin A; Andrews, Jason R; Jagannathan, Prasanna; Bhatt, Ami S.
  • Natarajan A; Department of Genetics, Stanford University, 269 Campus Dr, CCSR 1155b, Stanford, CA, USA.
  • Zlitni S; Department of Medicine (Hematology, Blood and Marrow Transplantation), Stanford University, Stanford, CA, USA.
  • Brooks EF; Department of Genetics, Stanford University, 269 Campus Dr, CCSR 1155b, Stanford, CA, USA.
  • Vance SE; Department of Medicine (Hematology, Blood and Marrow Transplantation), Stanford University, Stanford, CA, USA.
  • Dahlen A; Department of Medicine (Hematology, Blood and Marrow Transplantation), Stanford University, Stanford, CA, USA.
  • Hedlin H; Department of Medicine (Hematology, Blood and Marrow Transplantation), Stanford University, Stanford, CA, USA.
  • Park RM; Quantitative Science Unit, Stanford University, Stanford, CA, USA.
  • Han A; Quantitative Science Unit, Stanford University, Stanford, CA, USA.
  • Schmidtke DT; Department of Genetics, Stanford University, 269 Campus Dr, CCSR 1155b, Stanford, CA, USA.
  • Verma R; Department of Medicine (Hematology, Blood and Marrow Transplantation), Stanford University, Stanford, CA, USA.
  • Jacobson KB; Department of Microbiology and Immunology, Stanford University, Stanford, CA, USA.
  • Parsonnet J; Department of Microbiology and Immunology, Stanford University, Stanford, CA, USA.
  • Bonilla HF; Department of Medicine (Infectious Diseases and Geographic Medicine), Stanford University, Stanford, CA, USA.
  • Singh U; Department of Medicine (Infectious Diseases and Geographic Medicine), Stanford University, Stanford, CA, USA.
  • Pinsky BA; Department of Medicine (Infectious Diseases), Stanford University, Stanford, CA, USA.
  • Andrews JR; Department of Medicine (Epidemiology and Population Health), Stanford University, Stanford, CA, USA.
  • Jagannathan P; Department of Medicine (Infectious Diseases), Stanford University, Stanford, CA, USA.
  • Bhatt AS; Department of Medicine (Infectious Diseases and Geographic Medicine), Stanford University, Stanford, CA, USA.
Med (N Y) ; 3(6): 371-387.e9, 2022 06 10.
Article Dans Anglais | MEDLINE | ID: covidwho-1783640
ABSTRACT

Background:

COVID-19 manifests with respiratory, systemic, and gastrointestinal (GI) symptoms.1, SARS-CoV-2 RNA is detected in respiratory and fecal samples, and recent reports demonstrate viral replication in both the lung and intestinal tissue.2, 3, 4 Although much is known about early fecal RNA shedding, little is known about long-term shedding, especially in those with mild COVID-19. Furthermore, most reports of fecal RNA shedding do not correlate these findings with GI symptoms.5.

Methods:

We analyzed the dynamics of fecal RNA shedding up to 10 months after COVID-19 diagnosis in 113 individuals with mild to moderate disease. We also correlated shedding with disease symptoms.

Findings:

Fecal SARS-CoV-2 RNA is detected in 49.2% [95% confidence interval, 38.2%-60.3%] of participants within the first week after diagnosis. Whereas there was no ongoing oropharyngeal SARS-CoV-2 RNA shedding in subjects at 4 months, 12.7% [8.5%-18.4%] of participants continued to shed SARS-CoV-2 RNA in the feces at 4 months after diagnosis and 3.8% [2.0%-7.3%] shed at 7 months. Finally, we found that GI symptoms (abdominal pain, nausea, vomiting) are associated with fecal shedding of SARS-CoV-2 RNA.

Conclusions:

The extended presence of viral RNA in feces, but not in respiratory samples, along with the association of fecal viral RNA shedding with GI symptoms suggest that SARS-CoV-2 infects the GI tract and that this infection can be prolonged in a subset of individuals with COVID-19.

Funding:

This research was supported by a Stanford ChemH-IMA grant; fellowships from the AACR and NSF; and NIH R01-AI148623, R01-AI143757, and UL1TR003142.
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Texte intégral: Disponible Collection: Bases de données internationales Base de données: MEDLINE Sujet Principal: Maladies transmissibles / Maladies gastro-intestinales / COVID-19 Type d'étude: Étude diagnostique Les sujets: Covid long Limites du sujet: Humains langue: Anglais Revue: Med (N Y) Année: 2022 Type de document: Article Pays d'affiliation: J.medj.2022.04.001

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Texte intégral: Disponible Collection: Bases de données internationales Base de données: MEDLINE Sujet Principal: Maladies transmissibles / Maladies gastro-intestinales / COVID-19 Type d'étude: Étude diagnostique Les sujets: Covid long Limites du sujet: Humains langue: Anglais Revue: Med (N Y) Année: 2022 Type de document: Article Pays d'affiliation: J.medj.2022.04.001