With new and new research studies conducted around the world on this new virus, new discoveries have come up, some of which are shocking !! Many of us are aware about the gastro-intestinal symptoms of Covid-19. But recently studies have found some interesting facts about the presence of CORONA virus in stool and whether COVID can be transmitted through feces(stool) and whether stool of COVID patients is infectious? !! 

Read below to see what research studies have to say on this topic.



DIRECT ANSWER-

IS COVID-19 VIRUS PRESENT IN FECES OF PATIENTS? – YES

CAN CORONA DISEASE SPREAD THROUGH STOOL? – PROBABLY NO

Yes, this is an unexpected result that has been found by the scientists around the world. In all the studies, stools were tested using the traditional RT-PCR method of antigen testing.

Further detailed studies were performed to identify the duration of presence of Covid virus genetic material (RNA) in stool of patients and also if this corelates with the disease severity or symptoms. Also some interesting findings were found in case of children

But thankfully, no cases have been reported which states that the stools of covid patients are infective.

FOR HOW LONG IS CORONA VIRUS FOUND IN STOOL?

Usually, nasopharyngeal and oral swab samples are tested using RT-PCR as a method of testing if a patient has become corona negative and can be discharged or not.

But surprisingly, stools of covid patients can test positive even after the throat samples have turned negative and even after they have been discharged. This indicates that the virus particles were present in stool even when the symptoms were over.

When stools of covid patients were examined over a period of time, it was found that the stools tested positive of COVID-19  virus particles for 17-28 days after the onset of symptoms and for furthter 7-11 days after they were discharged.

CAN THIS BE AN ALTERNATIVE TO TRADITIONAL TESTING METHODS?

None of the tests is 100% acurate. Hence alternative methods of testing are used in cases of suspicion.

In the studies conducted, the testing of stools for infective agents was found to be equally accurate as compared to the traditional Covid testing methods.

So stool testing for covid virus, might provide an alternative mehod of testing corona, but not for intitial diagnosis as stools can get positive late following the infection.

CHILDREN

Few of the study results suggested an interesting data that stools of pediatric patients remained positive upto 20 days after their throat tests became negative! This is more than what has been found in adults.

This indicates that stools of children remain covid positive for prolonged time as compared to adult patients.

ANY RELATION WITH DISEASE SYMPTOM or SEVERITY?

CORONA disease can present with gastro-intestinal symptoms such as diarhea and vomiting. These are not present in all patients but can be found in 20% of the covid positive patients.
After knowing the presence of Covid-19 virus is the stools, studies were conducted to know whether these results were indicative of specific symptoms or indicate any severity in disease.
Surprisingly, no relation was found between presence of corona virus in stool with gastro-intesintal symptoms of corona.
In the studies conducted on covid positive patients, only 12-20% patients had gastrointestinal symptoms but still stools of 40-50% patients was tested positive in RT-PCR.
Severity of this disease is found on the basis of age, presence of number of symptom or certain blood reports. Accordingly, the further course of treatment and admission requirement is decided. 
No relation was found between the presence of covid in stool to the diseases symptom severity or admission requirements of patient.

Can stools of CORONA patients INFECT others?

The various studies which tested the stool of the covid patients tested the stools using RT-PCR method which came out to be positive for the presence of parts of genetic materials (RNA fragments). One of the studies showed that they were just fragments of the COVID RNA and not infectious viruses. 

Further, no confirmed cases have been found so far in the world which point towards transmission of covid infection from stools of patient.

Hence as of now, stool can be considered as non-infective but still, it is advisable to be careful.

WHO SHOULD BE CAREFUL?

Even though no incidences of transmision through stool have been confirmed, it is advised that people who work in places public toilets or sewage workers or are advised to take proper protection as they might get exposed to ‘faecal-aerosol-mucosal trasnmission’.

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SOURCES

  1. Infectious SARS-CoV-2 in Feces of Patient with Severe COVID-19″ by Fei Xiao and others in Emerg Infect Dis. 2020 Aug.
  2. Detectable SARS-CoV-2 viral RNA in feces of three children during recovery period of COVID-19 pneumonia” by Tongqiang Zhang and others in J Med Virol. 2020 Jul.
  3. Fecal specimen diagnosis 2019 novel coronavirus-infected pneumonia” by JingCheng Zhang and others in J Med Virol. 2020 Jun
  4. The presence of SARS-CoV-2 RNA in the feces of COVID-19 patients” by Yifei Chen and others in J Med Virol. 2020 Jul.
  5. Evaluation of SARS-CoV-2 RNA shedding in clinical specimens and clinical characteristics of 10 patients with COVID-19 in Macau” by Iek Long Lo and others in Int J Biol Sci. 2020.
  6. Prolonged viral shedding in feces of pediatric patients with coronavirus disease 2019″ by Yu-Han Xing and others in J Microbiol Immunol Infect. 2020 Jun.
  7. Factors Associated With Prolonged Viral RNA Shedding in Patients with Coronavirus Disease 2019 (COVID-19)” by Kaijin Xu and others in Clin Infect Dis. 2020.
  8. Prevalence of Gastrointestinal Symptoms and Fecal Viral Shedding in Patients With Coronavirus Disease 2019: A Systematic Review and Meta-analysis” by Sravanthi Parasa and others in JAMA Netw Open. 2020.
  9. Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From a Hong Kong Cohort: Systematic Review and Meta-analysis” by Ka Shing Cheung and others in Gastroenterology. 2020 Jul.
  10. Evaluation of SARS-CoV-2 viral RNA in fecal samples” by Alvaro Mesoraca et al. Virol J. 2020.
  11. Gastrointestinal involvement of COVID-19 and potential faecal transmission of SARS-CoV-2″ by Min Songand others
  12. Prolonged Fecal Shedding of SARS-CoV-2 in Pediatric Patients: A Quantitative Evidence Synthesis” by Victor S Santos and others in J Pediatr Gastroenterol Nutr. 2020 Aug.
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