Detection and Isolation of SARS-CoV-2 in Serum, Urine, and Stool Specimens of COVID-19 Patients from the Republic of Korea

Abstract

Coronavirus Disease-19 (COVID-19) is a respiratory infection characterized by the main symptoms of pneumonia and fever. It is caused by the novel coronavirus severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), which is known to spread via respiratory droplets. We aimed to determine the rate and likelihood of SARS-CoV-2 transmission from COVID-19 patients through nonrespiratory routes. Methods: Serum, urine, and stool samples were collected from 74 hospitalized patients diagnosed with COVID-19 based on the detection of SARS-CoV-2 in respiratory samples. The SARS-CoV-2 RNA genome was extracted from each specimen and real-time reverse transcription polymerase chain reaction performed. CaCo-2 cells were inoculated with the specimens containing the SARS-COV-2 genome, and subcultured for virus isolation. After culturing, viral replication in the cell supernatant was assessed. Results: Of the samples collected from 74 COVID-19 patients, SARS-CoV-2 was detected in 15 serum, urine, or stool samples. The virus detection rate in the serum, urine, and stool samples were 2.8% (9/323), 0.8% (2/247), and 10.1% (13/129), and the mean viral load was 1,210 ± 1,861, 79 ± 30, and 3,176 ± 7,208 copy/µL, respectively. However, the SARS-CoV-2 was not isolated by the culture method from the samples that tested positive for the SARS-CoV-2 gene. Conclusion: While the virus remained detectable in the respiratory samples of COVID-19 patients for several days after hospitalization, its detection in the serum, urine, and stool samples was intermittent. Since the virus could not be isolated from the SARS-COV-2-positive samples, the risk of viral transmission via stool and urine is expected to be low.

Potential sources, modes of transmission and effectiveness of prevention measures against SARS-CoV-2

“…One study including 46 patients with 16 of them reporting gastrointestinal manifestations (35%) reported diarrhea as the most common symptom (15%), followed by abdominal pain (11%), dyspepsia (11%), and nausea (2%) [116]. Analysing two groups of overall 12 patients, none of the stool samples resulted in successful virus isolation in cell culture, irrespective of viral RNA concentration [7,117]. In contrast, one study described the successful isolation of virus by cell culture from 2 out of 3 patients [118].…”

Is recurrence possible in coronavirus disease 2019 (COVID-19)? Case series and systematic review of literature

“…The inoculated cells were cultured for 5 days as above described. To evaluate the viral replication process, the cytopathic effect was observed at different exposure times, and RNA from the cell culture supernatant was extracted and assessed for the presence of SARS-CoV-2 using real-time RT-PCR [6,7]. The titer of IgG against the SARS-CoV-2 S1/S2 subunit of spike protein was measured with CLIA LIAISON® SARS-CoV-2 S1/ S2 IgG (DiaSorin).…”

Les Coronavirus humains

“…Le virus se réplique au niveau intestinal et les signes digestifs, en particulier la diarrhée, sont observés dans environ 10 % des cas [ 39 ]. Le virus est détectable de manière prolongée dans les selles par PCR mais on ne retrouve habituellement pas de virus infectieux dans ces échantillons [ 40 ].…”