TY - JOUR
T1 - Investigation of SARS-CoV-2 faecal shedding in the community: a prospective household cohort study (COVID-LIV) in the UK
AU - Vaselli, Natasha Marcella
AU - Setiabudi, Wega
AU - Subramaniam, Krishanthi
AU - Adams, Emily
AU - Turtle, Lance
AU - Iturriza-Gómara, Miren
AU - Solomon, Tom
AU - Cunliffe, Nigel A.
AU - French, Neil
AU - Hungerford, Daniel
AU - Hungerford, Daniel
AU - Vivancos, Roberto
AU - Gabbay, Mark
AU - Buchan, Iain
AU - Carrol, Enitan D.
AU - Gamble, Carrol
AU - Crossley, Lynnette
AU - Joseph, Neil
AU - Wilton, Moon
AU - Troughton, Lee D.
AU - Kilada, Samantha
AU - Abba, Katharine
AU - Simpson, Victoria
AU - Tulloch, John S.P.
AU - Goodwin, Lynsey
AU - Daws, Rachael
AU - Forootan, Shiva Seyed
AU - Dobson, Susan
AU - Press, Rachel
AU - Spaine, Vida
AU - Hands, Lesley
AU - Bradfield, Kate
AU - McNally, Carol
AU - Moitt, Tracy
AU - Balabanova, Silviya
AU - Donohue, Chloe
AU - Finnetty, Lynsey
AU - Marsh, Laura
AU - Greenhalf, William
AU - Naisbitt, Dean J.
AU - Shaw, Victoria E.
AU - Jones, Jayne
AU - Slack, Iain
AU - Mason, Jessica
AU - Edwards, Thomas
AU - McKeown, Claudia
AU - Williams, Chris
AU - Byrne, Rachel
AU - Garrod, Gala
AU - Owen, Sophie
PY - 2021/8/9
Y1 - 2021/8/9
N2 - BackgroundSARS-CoV-2 is frequently shed in the stool of patients hospitalised with COVID-19. The extent of faecal shedding of SARS-CoV-2 among individuals in the community, and its potential to contribute to spread of disease, is unknown.MethodsIn this prospective, observational cohort study among households in Liverpool, UK, participants underwent weekly nasal/throat swabbing to detect SARS-CoV-2 virus, over a 12-week period from enrolment starting July 2020. Participants that tested positive for SARS-CoV-2 were asked to provide a stool sample three and 14 days later. In addition, in October and November 2020, during a period of high community transmission, stool sampling was undertaken to determine the prevalence of SARS-CoV-2 faecal shedding among all study participants. SARS-CoV-2 RNA was detected using Real-Time PCR.ResultsA total of 434 participants from 176 households were enrolled. Eighteen participants (4.2%: 95% confidence interval [CI] 2.5–6.5%) tested positive for SARS-CoV-2 virus on nasal/throat swabs and of these, 3/17 (18%: 95% CI 4–43%) had SARS-CoV-2 detected in stool. Two of three participants demonstrated ongoing faecal shedding of SARS-CoV-2, without gastrointestinal symptoms, after testing negative for SARS-CoV-2 in respiratory samples. Among 165/434 participants without SARS-CoV-2 infection and who took part in the prevalence study, none had SARS-CoV-2 in stool. There was no demonstrable household transmission of SARS-CoV-2 among households containing a participant with faecal shedding.ConclusionsFaecal shedding of SARS-CoV-2 occurred among community participants with confirmed SARS-CoV-2 infection. However, during a period of high community transmission, faecal shedding of SARS-CoV-2 was not detected among participants without SARS-CoV-2 infection. It is unlikely that the faecal-oral route plays a significant role in household and community transmission of SARS-CoV-2.
AB - BackgroundSARS-CoV-2 is frequently shed in the stool of patients hospitalised with COVID-19. The extent of faecal shedding of SARS-CoV-2 among individuals in the community, and its potential to contribute to spread of disease, is unknown.MethodsIn this prospective, observational cohort study among households in Liverpool, UK, participants underwent weekly nasal/throat swabbing to detect SARS-CoV-2 virus, over a 12-week period from enrolment starting July 2020. Participants that tested positive for SARS-CoV-2 were asked to provide a stool sample three and 14 days later. In addition, in October and November 2020, during a period of high community transmission, stool sampling was undertaken to determine the prevalence of SARS-CoV-2 faecal shedding among all study participants. SARS-CoV-2 RNA was detected using Real-Time PCR.ResultsA total of 434 participants from 176 households were enrolled. Eighteen participants (4.2%: 95% confidence interval [CI] 2.5–6.5%) tested positive for SARS-CoV-2 virus on nasal/throat swabs and of these, 3/17 (18%: 95% CI 4–43%) had SARS-CoV-2 detected in stool. Two of three participants demonstrated ongoing faecal shedding of SARS-CoV-2, without gastrointestinal symptoms, after testing negative for SARS-CoV-2 in respiratory samples. Among 165/434 participants without SARS-CoV-2 infection and who took part in the prevalence study, none had SARS-CoV-2 in stool. There was no demonstrable household transmission of SARS-CoV-2 among households containing a participant with faecal shedding.ConclusionsFaecal shedding of SARS-CoV-2 occurred among community participants with confirmed SARS-CoV-2 infection. However, during a period of high community transmission, faecal shedding of SARS-CoV-2 was not detected among participants without SARS-CoV-2 infection. It is unlikely that the faecal-oral route plays a significant role in household and community transmission of SARS-CoV-2.
KW - Asymptomatic
KW - Cohort study
KW - Community
KW - COVID-19
KW - Faecal shedding
KW - Gastrointestinal
KW - SARS-CoV-2
KW - Transmission
U2 - 10.1186/s12879-021-06443-7
DO - 10.1186/s12879-021-06443-7
M3 - Article
SN - 1471-2334
VL - 21
SP - 784
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
IS - 1
M1 - 784
ER -