Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes

Abstract

In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oralfecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.

COVID-19—New Insights on a Rapidly Changing Epidemic

“…5 The reproductive number (R 0 ) (the expected number of secondary cases produced by a single infected person in a susceptible population) for SARS-CoV-2, although still preliminary, is estimated between 2 and 3, suggesting a higher pandemic potential than SARS. Transmission from an asymptomatic carrier appears to be possible, 3,4 which, if confirmed in larger studies, will have important implications for screening and isolation. A report of 9 pregnant patients suggests that perinatal transmission is unlikely but larger studies are needed to confirm this finding.…”

The epidemiology, diagnosis and treatment of COVID-19

“…The overall positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan was 38% [24] . The positive rate of PCR for oropharyngeal swabs is not very high: only 53.3% of COVID-19-confirmed patients had positive oral swabs tests [25] . In a series of 51 patients with confirmed COVID-19 infection, 71% patients were RT-PCR positive at the first time of testing of throat swab or sputum samples [26] .…”

Rapid colorimetric detection of COVID-19 coronavirus using a reverse transcriptional loop-mediated isothermal amplification (RT-LAMP) diagnostic platform: iLACO

“…In December 2019, the first case of cluster unidentified pneumonia was found in Wuhan, named 2019-Novel Coronavirus (2019-nCoV), a beta subtype, highly homologous with SARS (1). As of February 18, 2020, there were in total 75,201 confirmed cases worldwide.…”