1. SARS-CoV-2 viral shedding characteristics and potential evidence for the priority for faecal specimen testing in diagnosis
- Author
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Hai Wang, Chen Yuan, Bing Wu, Yongli Zhang, Jiabei Chen, Songye Gu, Yaxin Dai, Shelan Liu, Kefeng Li, Wen-jie Wu, Mingyu Wu, Zhendong Tong, An Tang, Yuchao Wang, Meng-lu Yu, Jie-nan Liu, Xinwei Yu, Hui Zhang, Jialu He, Jian-Bo Yan, Hongling Wang, and Haodi Xu
- Subjects
Male ,RNA viruses ,Viral Diseases ,Coronaviruses ,Physiology ,Cross-sectional study ,Respiratory System ,Disease ,Feces ,COVID-19 Testing ,Medical Conditions ,0302 clinical medicine ,Medicine and Health Sciences ,030212 general & internal medicine ,Child ,Pathology and laboratory medicine ,Virus Testing ,Aged, 80 and over ,Multidisciplinary ,Middle Aged ,Medical microbiology ,Viral Load ,Virus Shedding ,Infectious Diseases ,medicine.anatomical_structure ,Child, Preschool ,030220 oncology & carcinogenesis ,Viruses ,Medicine ,Female ,SARS CoV 2 ,Pathogens ,Viral load ,Research Article ,Adult ,China ,Viral Release ,medicine.medical_specialty ,Adolescent ,SARS coronavirus ,Infectious Disease Control ,Science ,Research and Analysis Methods ,Microbiology ,Specimen Handling ,Young Adult ,03 medical and health sciences ,Diagnostic Medicine ,Virology ,Internal medicine ,medicine ,Humans ,Viral shedding ,Secretion ,Aged ,business.industry ,Infant, Newborn ,Organisms ,Viral pathogens ,COVID-19 ,Infant ,Biology and Life Sciences ,Covid 19 ,Microbial pathogens ,Cross-Sectional Studies ,Specimen Preparation and Treatment ,Physiological Processes ,business ,Asymptomatic carrier ,Viral Transmission and Infection ,Respiratory tract - Abstract
This study aimed to identify the specimen type that has high positivity and its proper sampling time for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing to promote diagnostic efficiency. All SARS-CoV-2-infected patients with a laboratory-confirmed diagnosis in Zhoushan City were followed up for viral shedding in respiratory tract specimens and faecal samples. Positivity was analysed both qualitatively and quantitatively by proper statistical approaches with strong testing power. Viral shedding in respiratory tract and faecal specimens was prolonged to 45 and 40 days after the last exposure, respectively. The overall positive rate in respiratory tract specimens was low and relatively unstable, being higher in the early-to-mid stage than in the mid-to-late stage of the disease course. Compared with respiratory tract specimens, faecal samples had a higher viral load, higher overall positive rate, and more stable positivity in different disease courses and varied symptomatic status. Faecal specimens have the potential ability to surpass respiratory tract specimens in virus detection. Testing of faecal specimens in diagnosis, especially for identifying asymptomatic carriers, is recommended. Simultaneously, testing respiratory tract specimens at the early-to-mid stage is better than testing at the mid-to-late stage of the disease course. A relatively small sample size was noted, and statistical approaches were used to address it. Information was missing for both specimen types at different stages of the disease course due to censored data. Our research extends the observed viral shedding in both specimen types and highlights the importance of faecal specimen testing in SARS-CoV-2 diagnosis. Healthcare workers, patients, and the general public may all benefit from our study findings. Disposal of sewage from hospitals and residential areas should be performed cautiously because the virus sheds in faeces and can last for a long time.
- Published
- 2021