COVID-19 Infects GI Tract, a Potential Way of Viral Transmission

The Chinese researchers are cautioning that the novel corona virus infection (Covid-19) causing virus that has affected millions of people both in China and across the world, can possibly be transmitted through feces.

In the reports published online in Gastroenterology, found that the feces of more than half the people infected with SARS-CoV- 2 contains the virus. Certain patients get diarrhea while the others vomit; some are tested positive for virus in the feces despite being tested negative for pathogens in their respiratory tests.

Douglas Corley, MD, Ph.D., a gastroenterologist and research scientist at Kaiser Permanente, Northern California, the director of delivery science and applied research and also the co-editor of Gastroenterology says, if the transmission of this virus is understood, the spread of virus can be effectively prevented but this was not a part of the research conducted. He also said that such observations can help in improving the efficiency of the diagnosis by testing for the presence of virus in the feces of individuals those are suspects of corona virus.

Dr. Fei Xiao, MD, Ph.D. along with the team, belonging to the Fith Affiliated Hospital located in Guangzhou, China, conducted a study related to the previous finding of SARS-CoV-2 RNA in the feces of an infected individual. They performed a polymerase chain reaction test on 71 patients who were admitted for Covid-19 between Feb 1, 2020, and Feb 14, 2020. The team also studied the duodenal, gastric, oesophageal and rectal biopsies taken from a Covid-19 patient who had to undergo endoscopy while being treated in the hospital during this time.

They found that the feces of 53.4% of patients had presence of SARS-CoV-2 RNA, and 23% of patients were tested positive in their feces even though they were tested negative for the Covid-19 virus in their respiratory samples.

This shows that even after the virus is cleared in the respiratory tract oral transmission is still possible through viral gastrointestinal infection and potential fecal. Thus, the team recommends that the Real-Time reverse transcription (rRT)- PCR test for SARS-CoV-2 should be done from feces at regular intervals. Necessary precautions must be taken by the hospitals accordingly if the feces of the infected individual is positive in the rRT-PCR testing.

The researchers found that the feces of the patient who has undergone the endoscopy contained many interstitial edema, lymphocytes, infiltrating plasma cells in the lamina propria of the duodenum, stomach and rectum.

In a different study conducted by the MD of the Department of Transplantation at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine in Shanghai, China, Dr. Jinyang Gu, and colleagues something significant was found. It was observed by them that when SARS (Severe Acute Respiratory Syndrome) spread in the year 2003, virus was detected in the biopsy specimens and feces of even the patients who were treated and sent home.

The first individual to be diagnosed with SARS-CoV-2 in the US suffered from vomiting and nausea for two days before, the person visited the hospital. The patient has loose bowel movements at the time of hospital treatment. The patient’s respiratory and feces specimen showed positive results for SARS-CoV-2, the researchers said.

The clinical evidence reveals that the digestive system could be an alternate route for the SARS-CoV-2 infection along with the respiratory tract. The researchers stressed over the fact that the clinicians must ensure to identify the patients that show initial gastrointestinal symptoms.

Dr. Gu, along with his team, also found that certain Covid-19 patients also displayed signs of mild to moderate liver injuries. However, the effect of this new virus on the liver is still not clear unlike the time of SARS outbreak in 2003 when the biopsies from liver tissues of the infected people confirmed hepatic infection. A recent data from two different organizations reveal that person infected by SARS-CoV-2 will suffer from damages of intrahepatic bile ducts.

To sum it up, researches and efforts must be made to detect the initial digestive symptoms of Covid-19 at an early stage, so necessary measures can be taken by the medical staff for its prevention and cure.

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