Fecal dissemination of SARS-CoV-2 virus genome in COVID-19 patients in India

Fecal dissemination of SARS-CoV-2 virus genome in COVID-19 patients in India. Spencer EA, Heneghan C.

https://www.cebm.net/study/fecal-dissemination-of-sars-cov-2-virus-genome-in-covid-19-patients-in-india/

Published on July 16, 2020

Reference Senapati S, Kshatri JS, Prasad P et al. A pilot study to investigate the fecal dissemination of SARS-CoV-2 virus genome in COVID-19 patients in Odisha, India. medRxiv 2020.05.26.20113167; doi: https://doi.org/10.1101/2020.05.26.20113167
Study type
Country India
Setting Hospital
Funding Details Non Reported
Transmission mode Orofecal
Exposures

Bottom Line

This pilot study in India found SARS-CoV-2 RNA in fecal samples from 12 symptomatic and asymptomatic COVID-19 patients.

Evidence Summary

SARS-CoV-2 RNA was identified in fecal samples from 12 COVID-19 patients, some of whom were asymptomatic  Transmission of infectious virus was not confirmed by this study

The study established a protocol to collect and extract viral RNA for SARS-CoV-2 detection in fecal samples.

What did they do?

This was a pilot study to investigate fecal dissemination of the SARS-CoV-2 genome among Indian COVID-19 patients. 

Patients admitted to a COVID-19 hospital were tested by nasopharyngeal swab and rectal swab, performed on the same day. These were tested for SARS-CoV-2 by reverse transcription-polymerase chain reaction (RT-PCR).

Study reliability

This is a pilot study and not sufficiently powered to generate reliable findings – the study sets up the protocol for a large study to investigate possible transmission.  It is unclear how the 12 patients for whom data are presented were selected. 

Clearly defined setting Demographic characteristics described Follow-up length was sufficient Transmission outcomes assessed Main biases are taken into consideration
Unclear Yes N/A N/A No

What else should I consider?

It is unclear why patients who were asymptomatic had been admitted as it was a COVID-19 hospital, or if they mean that patients had become asymptomatic during their hospital stay but nevertheless gave nasopharyngeal and rectal samples. 

Next research steps are to perform a large study to correlate the significance of the SARS-CoV-2 virus genome detection in fecal samples with disease severity and transmission.

About the authors

Carl Heneghan

Carl Heneghan

Carl is Professor of EBM & Director of CEBM at the University of Oxford. He is also a GP and tweets @carlheneghan. He has an active interest in discovering the truth behind health research findings

Elizabeth Spencer

Elizabeth Spencer

Dr Elizabeth Spencer; MMedSci, PhD. Epidemiologist, Nuffield Department for Primary Care Health Sciences, University of Oxford.

Tom Jefferson

Tom Jefferson

Tom Jefferson is a senior associate tutor and honorary research fellow, Centre for Evidence-Based Medicine, University of Oxford.