SARS-CoV-2-positive sputum and feces samples in COVID-19 patients

SARS-CoV-2-positive sputum and feces samples in COVID-19 patients. Spencer EA, Heneghan C.

https://www.cebm.net/study/sars-cov-2-positive-sputum-and-feces-samples-in-covid-19-patients/

Published on July 15, 2020

Reference Chen C, Gao G, Xu Y, et al. SARS-CoV-2-positive sputum and feces after conversion of pharyngeal samples in patients with COVID-19. Ann Intern Med. 2020;172(12):832-834. doi:10.7326/M20-0991 1900
Study type
Country China
Setting Hospital
Funding Details This work is funded by Beijing Science and Technology Commission.
Transmission mode Orofecal
Exposures

Bottom Line

This retrospective study of 133 hospitalised COVID-19 patients identified 22 whose sputum or fecal samples tested positive after their pharyngeal swabs became negative.

Evidence Summary

Records of tests for 133 patients admitted with COVID-19 from 20 January to 27 February 2020 were available. Twenty two of 133 patients (four of whom were children) with an initial or follow-up positive sputum or fecal samples paired with a follow-up negative pharyngeal sample were identified.

What did they do?

This study assessed the results of real-time quantitative fluorescence polymerase chain reaction (RT-qPCR) for SARS–CoV2 RNA of sputum and fecal samples from a group of hospitalised COVID-19 patients, after conversion of their pharyngeal samples from positive to negative.

A convenience sample was retrospectively identified, of patients admitted to Beijing Ditan Hospital, Capital Medical University, with a diagnosis of COVID-19 and paired RT-qPCR testing of pharyngeal swabs with either sputum or feces samples. Among 133 patients admitted with COVID-19 from 20 January to 27 February 2020, 22 patients (4 of whom were children) with an initial or follow-up positive sputum or fecal samples paired with a follow-up negative pharyngeal sample were identified.

From these 22 patients, 545 samples were available, including 209 pharyngeal swabs, 262 sputum samples, and 74 feces samples.

Study reliability

This study is at high risk of bias due to the selection of included data: the study used a convenience sample rather than serial samples being obtained from each patient on a predefined protocol.

Clearly defined setting Demographic characteristics described Follow-up length was sufficient Transmission outcomes assessed Main biases are taken into consideration
Yes Yes N/A N/A Unclear

What else should I consider?

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.