Investigation of SARS-CoV-2 faecal shedding in the community: a prospective household cohort study (COVID-LIV) in the UK

Vaselli, Natasha Marcella, Setiabudi, Wega ORCID: 0000-0003-2510-0318, Subramaniam, Krishanthi ORCID: 0000-0002-1734-9351, Adams, Emily R, Turtle, Lance ORCID: 0000-0002-0778-1693, Iturriza-Gomara, Miren ORCID: 0000-0001-5816-6423, Solomon, Tom ORCID: 0000-0001-7266-6547, Cunliffe, Nigel A ORCID: 0000-0002-5449-4988, French, Neil ORCID: 0000-0003-4814-8293 and Hungerford, Daniel ORCID: 0000-0002-9770-0163 (2021) Investigation of SARS-CoV-2 faecal shedding in the community: a prospective household cohort study (COVID-LIV) in the UK. BMC INFECTIOUS DISEASES, 21 (1). 784-.

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Abstract

<h4>Background</h4>SARS-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.<h4>Methods</h4>In 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.<h4>Results</h4>A 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.<h4>Conclusions</h4>Faecal 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.

Item Type:	Article
Uncontrolled Keywords:	SARS-CoV-2, COVID-19, Cohort study, Faecal shedding, Transmission, Community, Asymptomatic, Gastrointestinal
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User:	Symplectic Admin
Date Deposited:	11 Aug 2021 08:25
Last Modified:	18 Jan 2023 21:33
DOI:	10.1186/s12879-021-06443-7
Open Access URL:	https://doi.org/10.1186/s12879-021-06443-7
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3133030