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Article ; Online: Fecal transmission in COVID-19: A potential shedding route.

Nouri-Vaskeh, Masoud / Alizadeh, Leila

2020 Volume 92, Issue 10, Page(s) 1731–1732

MeSH term(s)	COVID-19 ; Coronavirus Infections/epidemiology ; Feces ; Humans ; Pandemics ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-04-06
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	752392-0
ISSN	1096-9071 ; 0146-6615
ISSN (online)	1096-9071
ISSN	0146-6615
DOI	10.1002/jmv.25816
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Article: Fecal transmission in COVID-19: A potential shedding route

Nouri-Vaskeh, Masoud / Alizadeh, Leila

J. med. virol

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32239515
Database	COVID19

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Article ; Online: Fecal transmission in COVID‐19

Nouri‐Vaskeh, Masoud / Alizadeh, Leila

Journal of Medical Virology

A potential shedding route

2020 Volume 92, Issue 10, Page(s) 1731–1732

Keywords	Virology ; Infectious Diseases ; covid19
Language	English
Publisher	Wiley
Publishing country	us
Document type	Article ; Online
ZDB-ID	752392-0
ISSN	1096-9071 ; 0146-6615
ISSN (online)	1096-9071
ISSN	0146-6615
DOI	10.1002/jmv.25816
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Is SARS-CoV-2 Also an Enteric Pathogen With Potential Fecal-Oral Transmission? A COVID-19 Virological and Clinical Review.

Ding, Siyuan / Liang, T Jake

Gastroenterology

2020 Volume 159, Issue 1, Page(s) 53–61

Abstract: ... many of its related viruses, may also be an enteric virus that can spread via the fecal-oral route. Such a hypothesis ... In as few as 3 months, coronavirus disease 2019 (COVID-19) has spread and ravaged the world ... for potential human-to-human transmission. ...

Abstract	In as few as 3 months, coronavirus disease 2019 (COVID-19) has spread and ravaged the world at an unprecedented speed in modern history, rivaling the 1918 flu pandemic. Severe acute respiratory syndrome coronavirus-2, the culprit virus, is highly contagious and stable in the environment and transmits predominantly among humans via the respiratory route. Accumulating evidence suggest that this virus, like many of its related viruses, may also be an enteric virus that can spread via the fecal-oral route. Such a hypothesis would also contribute to the rapidity and proliferation of this pandemic. Here we briefly summarize what is known about this family of viruses and literature basis of the hypothesis that severe acute respiratory syndrome coronavirus-2 is capable of infecting the gastrointestinal tract and shedding in the environment for potential human-to-human transmission.
MeSH term(s)	Animals ; Betacoronavirus/isolation & purification ; Betacoronavirus/pathogenicity ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/transmission ; Coronavirus Infections/virology ; Feces/virology ; Gastrointestinal Tract/virology ; Humans ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/transmission ; Pneumonia, Viral/virology ; SARS-CoV-2 ; Virus Shedding
Keywords	covid19
Language	English
Publishing date	2020-04-27
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80112-4
ISSN	1528-0012 ; 0016-5085
ISSN (online)	1528-0012
ISSN	0016-5085
DOI	10.1053/j.gastro.2020.04.052
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Article: Is SARS-CoV-2 Also an Enteric Pathogen With Potential Fecal-Oral Transmission? A COVID-19 Virological and Clinical Review

Ding, Siyuan / Liang, T Jake

Gastroenterology

Abstract	In as few as 3 months, coronavirus disease 2019 (COVID-19) has spread and ravaged the world at an unprecedented speed in modern history, rivaling the 1918 flu pandemic. Severe acute respiratory syndrome coronavirus-2, the culprit virus, is highly contagious and stable in the environment and transmits predominantly among humans via the respiratory route. Accumulating evidence suggest that this virus, like many of its related viruses, may also be an enteric virus that can spread via the fecal-oral route. Such a hypothesis would also contribute to the rapidity and proliferation of this pandemic. Here we briefly summarize what is known about this family of viruses and literature basis of the hypothesis that severe acute respiratory syndrome coronavirus-2 is capable of infecting the gastrointestinal tract and shedding in the environment for potential human-to-human transmission.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #125255
Database	COVID19

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Article ; Online: Prolonged viral shedding in feces of children with COVID-19: a systematic review and synthesis of data.

Li, Wen-Ting / Zhang, Yun / Liu, Miao / Liu, Yan-Qin / Ma, Xiang

European journal of pediatrics

2022 Volume 181, Issue 12, Page(s) 4011–4017

Abstract: ... the duration of fecal viral shedding in children with COVID-19. We found that in about 60% of the cases ... of longer fecal viral shedding duration of children. Conclusion: Children with COVID-19 show prolonged ... Children with COVID-19 carried a longer-term fecal viral shedding than adults. • The poor hand hygiene ...

Abstract	During the coronavirus disease 2019 (COVID-19) epidemic, many reports have indicated that children shed the virus longer than adults in stool, and that most of the children had mild or even asymptomatic infections, which increased the potential risk for feces to be a source of contamination and may play an important role in the spread of the virus. In this review, we collected relevant literature to summarize the duration of fecal viral shedding in children with COVID-19. We found that in about 60% of the cases, the fecal shedding time was between 28 and 42 days, which was much longer than that of adults. We further explored the possible reason for prolonged shedding and its the potential impact. The poor hand hygiene practices of children, their tendency to swallow sputum and/or saliva, the significant difference in expression of angiotensin-converting enzyme 2 (ACE2) in intestine between children and adults, and the variance in immune status and intestinal microbiome could be considered as potential casual agents of longer fecal viral shedding duration of children. Conclusion: Children with COVID-19 show prolonged fecal shedding compared to adults. Several mechanisms may be involved in the longer fecal viral shedding. Viral shedding in the stool could be contributing to a possible route of transmission. Therefore, we think that further preventive measures in children should be taken to reduce the spread of the disease. What is Known: • Children with COVID-19 are more likely to have asymptomatic infections and to experience mild symptoms. • Some patients continue to shed the virus in feces, despite respiratory samples testing negative. What is New: • Children with COVID-19 carried a longer-term fecal viral shedding than adults. • The poor hand hygiene practices of children, their tendency to swallow sputum and/or saliva, the difference in expression of ACE2 in intestine between children and adults, and the variance in immune status and intestinal microbiome could be considered as potential casual agents of longer fecal viral shedding duration of children.
MeSH term(s)	Child ; Adult ; Humans ; Virus Shedding ; COVID-19 ; Angiotensin-Converting Enzyme 2 ; SARS-CoV-2 ; Asymptomatic Infections ; RNA, Viral ; Feces
Chemical Substances	Angiotensin-Converting Enzyme 2 (EC 3.4.17.23) ; RNA, Viral
Language	English
Publishing date	2022-09-17
Publishing country	Germany
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-022-04622-5
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Article ; Online: SARS-CoV-2 and the role of orofecal transmission: a systematic review.

Heneghan, Carl J / Spencer, Elizabeth A / Brassey, Jon / Plüddemann, Annette / Onakpoya, Igho J / Evans, David H / Conly, John M / Jefferson, Tom

F1000Research

2021 Volume 10, Page(s) 231

Abstract: ... could, in addition to droplet and fomite transmission, be transmitted via the orofecal route.: Methods ... from COVID-19 patients' fecal samples: culture was successful in 3 of 6 studies, and one study demonstrated ... This review is part of an Open Evidence Review on Transmission Dynamics of COVID-19. We conduct ongoing ...

Abstract	Background: Modes of transmission of SARS-CoV-2 are of key public health importance. SARS-CoV-2 has been detected in the feces of some COVID-19 patients, suggesting the possibility that the virus could, in addition to droplet and fomite transmission, be transmitted via the orofecal route. Methods: This review is part of an Open Evidence Review on Transmission Dynamics of COVID-19. We conduct ongoing searches using WHO COVID-19 Database, LitCovid, medRxiv, and Google Scholar; assess study quality based on five criteria and report important findings. Where necessary, authors are contacted for further details on the content of their articles. Results: We include searches up until 20 December 2020. We included 110 relevant studies: 76 primary observational studies or reports, and 35 reviews (one cohort study also included a review) examining the potential role of orofecal transmission of SARS-CoV-2. Of the observational studies, 37 were done in China. A total of 48 studies (n=9,081 patients) reported single cases, case series or cohort data on individuals with COVID-19 diagnosis or their contacts and 46 (96%) detected binary RT-PCR with 535 out of 1358 samples positive for SARS-CoV-2 (average 39.4%). The results suggest a long duration of fecal shedding, often recorded after respiratory samples tested negative, and symptoms of gastrointestinal disease were reported in several studies. Twenty-nine studies reported finding SARS-CoV-2 RNA in wastewater, river water or toilet areas. Six studies attempted viral culture from COVID-19 patients' fecal samples: culture was successful in 3 of 6 studies, and one study demonstrated invasion of the virus into intestinal epithelial cells. Conclusions: Varied observational and mechanistic evidence suggests SARS-CoV-2 can infect and be shed from the gastrointestinal tract, including some data demonstrating viral culture in fecal samples. To fully assess these risks, quantitative data on infectious virus in these settings and infectious dose are needed.
MeSH term(s)	COVID-19 ; COVID-19 Testing ; Cohort Studies ; Humans ; RNA, Viral ; SARS-CoV-2
Chemical Substances	RNA, Viral
Language	English
Publishing date	2021-03-24
Publishing country	England
Document type	Systematic Review
ZDB-ID	2699932-8
ISSN	2046-1402 ; 2046-1402
ISSN (online)	2046-1402
ISSN	2046-1402
DOI	10.12688/f1000research.51592.2
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Prolonged Shedding of SARS-CoV-2 in Feces of COVID-19 Positive Patients: Trends in Genomic Variation in First and Second Wave.

Lavania, Mallika / Joshi, Madhuri S / Ranshing, Sujata S / Potdar, Varsha A / Shinde, Manohar / Chavan, Nutan / Jadhav, Santosh M / Sarkale, Prasad / Mohandas, Sreelekshmy / Sawant, Pradeep M / Tikute, Sanjaykumar / Padbidri, Vikram / Patwardhan, Sampada / Kate, Rohan

Frontiers in medicine

2022 Volume 9, Page(s) 835168

Abstract: ... Our study focused on the investigation of SARS-CoV-2 shedding in the fecal samples of patients ... The main route of the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV ... of a fecal-oral mode of transmission has been accumulating. The diagnosis of SARS-COV-2 infected cases is ...

Abstract	The main route of the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are through respiratory pathways and close contact of human-to-human. While information about other modes of transmission is comparatively less, some published literature supporting the likelihood of a fecal-oral mode of transmission has been accumulating. The diagnosis of SARS-COV-2 infected cases is based on the real-time reverse transcription-PCR (RT-PCR). The fecal excretion of SARS-COV-2 has been reported frequently, however, the role of fecal viral load with the severity of disease is not yet clear. Our study focused on the investigation of SARS-CoV-2 shedding in the fecal samples of patients with coronavirus disease 2019 (COVID-19). A total of 280 RT-PCR-positive patients were enrolled, among them 15.4% had gastrointestinal (GI) symptoms. It was shown that 62% of the patients were positive for SARS-CoV-2 RNA in fecal specimens. This positivity was not related to the presence of GI symptoms and the severity of disease. The next generation sequencing [NGS] of SARS-CoV-2 from fecal samples of patients was performed to analyze mutational variations. Findings from this study not only emphasized the potential presence of SARS-CoV-2 in feces, but also its continuing mutational changes and its possible role in fecal-oral transmission.
Language	English
Publishing date	2022-03-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2022.835168
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Article ; Online: SARS-CoV-2 and the role of orofecal transmission

Tom Jefferson / John M. Conly / David H. Evans / Carl J. Heneghan / Igho J. Onakpoya / Annette Plüddemann / Jon Brassey / Elizabeth A. Spencer

F1000Research, Vol

a systematic review [version 2; peer review: 2 approved]

2021 Volume 10

Abstract: ... could, in addition to droplet and fomite transmission, be transmitted via the orofecal route. Methods: This review is ... from COVID-19 patients’ fecal samples: culture was successful in 3 of 6 studies, and one study demonstrated ... part of an Open Evidence Review on Transmission Dynamics of COVID-19. We conduct ongoing searches using ...

Abstract	Background: Modes of transmission of SARS-CoV-2 are of key public health importance. SARS-CoV-2 has been detected in the feces of some COVID-19 patients, suggesting the possibility that the virus could, in addition to droplet and fomite transmission, be transmitted via the orofecal route. Methods: This review is part of an Open Evidence Review on Transmission Dynamics of COVID-19. We conduct ongoing searches using WHO COVID-19 Database, LitCovid, medRxiv, and Google Scholar; assess study quality based on five criteria and report important findings. Where necessary, authors are contacted for further details on the content of their articles. Results: We include searches up until 20 December 2020. We included 110 relevant studies: 76 primary observational studies or reports, and 35 reviews (one cohort study also included a review) examining the potential role of orofecal transmission of SARS-CoV-2. Of the observational studies, 37 were done in China. A total of 48 studies (n=9,081 patients) reported single cases, case series or cohort data on individuals with COVID-19 diagnosis or their contacts and 46 (96%) detected binary RT-PCR with 535 out of 1358 samples positive for SARS-CoV-2 (average 39.4%). The results suggest a long duration of fecal shedding, often recorded after respiratory samples tested negative, and symptoms of gastrointestinal disease were reported in several studies. Twenty-nine studies reported finding SARS-CoV-2 RNA in wastewater, river water or toilet areas. Six studies attempted viral culture from COVID-19 patients’ fecal samples: culture was successful in 3 of 6 studies, and one study demonstrated invasion of the virus into intestinal epithelial cells. Conclusions: Varied observational and mechanistic evidence suggests SARS-CoV-2 can infect and be shed from the gastrointestinal tract, including some data demonstrating viral culture in fecal samples. To fully assess these risks, quantitative data on infectious virus in these settings and infectious dose are needed.
Keywords	Orofecal ; transmission ; COVID-19 ; SARS-CoV-2 ; systematic review ; eng ; Medicine ; R ; Science ; Q
Subject code	306
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	F1000 Research Ltd
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: SARS-CoV-2 and the Role of Orofecal Transmission: Systematic Review

Heneghan, Carl / Spencer, Elizabeth / Brassey, Jon / Jefferson, Tom

medRxiv

Abstract: ... on Transmission Dynamics of Covid-19. We conduct ongoing searches using LitCovid, medRxiv, Google Scholar and ... detected in the feces of some Covid-19 patients which suggests the possibility that the virus ... could additionally be transmitted via the orofecal route. Methods This review is part of an Open Evidence Review ...

Abstract	Background How SARS-CoV-2 is transmitted is of key public health importance. SARS-CoV-2 has been detected in the feces of some Covid-19 patients which suggests the possibility that the virus could additionally be transmitted via the orofecal route. Methods This review is part of an Open Evidence Review on Transmission Dynamics of Covid-19. We conduct ongoing searches using LitCovid, medRxiv, Google Scholar and Google for Covid-19; assess study quality based on five criteria and report important findings on an ongoing basis. Where necessary authors are contacted for further details or clarification on the content of their articles. Results We found 59 studies: nine reviews and 51 primary studies or reports (one cohort study also included a review) examining the potential role of orofecal transmission of SARS-CoV-2. Half (n=29) were done in China. Thirty seven studies reported positive fecal samples for SARS-CoV-2 based on RT-PCR results (n=1,034 patients). Six studies reported isolating the virus from fecal samples of nine patients, one study isolated the virus from rectal tissue and one laboratory study found that SARS-CoV-2 productively infected human small intestinal organoids. Eleven studies report on fecal samples found in sewage, and two sampled bathrooms and toilets. Conclusions Various observational and mechanistic evidence support the hypothesis that SARS-CoV-2 can infect and be shed from the human gastrointestinal tract. Policy should emphasize the importance of strict personal hygiene measures, and chlorine-based disinfection of surfaces in locations where there is presumed or known SARS-CoV-2 activity.
Keywords	covid19
Language	English
Publishing date	2020-08-10
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2020.08.04.20168054
Database	COVID19

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