Fecal specimen diagnosis of novel coronavirus‐infected pneumonia

Fecal specimen diagnosis of novel coronavirus‐infected pneumonia. Spencer EA, Heneghan C.


Published on July 1, 2020

Reference Zhang J, Wang S, Xue Y. Fecal specimen diagnosis 2019 novel coronavirus‐infected pneumonia. J Med Virol. 2020. 2020
Study type
Country China
Setting Hospital
Funding Details Non reported
Transmission mode Orofecal
Exposures Hospital patients with COVID-19 pneumonia

Bottom Line

A small pilot sample of 14 cases  indicated agreement for the presence of COVID-19 between oropharyngeal sample and fecal samples.

Evidence Summary

Five of 14 (oropharyngeal sample PCR) confirmed patients had a positive stool sample for COVID‐19 nucleic acid 

Patients with positive stool samples were also positive for oropharyngeal swabs specimens at least the day before (see Figure, copied below); patients with negative stool samples were also negative for oropharyngeal swabs for at least the first 2 days (see Figure, copied below). 

The presence of SARS-Cov-2 nucleic acid in stool samples was not related to the severity of lung disease (nor to gastrointestinal since none of these patients had GI symptoms).

What did they do?

A retrospective analysis of samples taken from 14 laboratory‐diagnosed patients with COVID‐19 pneumonia. Amongst these patients, none had diarrhoea and vomiting. 

These patients were hospitalized from 27th January to 10th February 2020, with final follow‐up for this report on the 9th February 2020. 

The hospital commenced taking stool samples, in addition to oropharyngeal, on 4th February.

Study reliability

This is a small pilot study and needs replication with prespecified methods and a large sample size.

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

What else should I consider?

About the authors

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

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