129 CMAAO
CORONA FACTS and MYTH BUSTER GI symptoms
Dr K K Aggarwal
President CMAAO
951: Four in 10 Patients with Coronavirus
Infection Shed Virus in Stool
Reuters excerpt: 12% of COVID 19 patients experience
gastrointestinal symptoms [diarrhea, nausea and vomiting]
40.5% have viral RNA in their stool.
In a meta-analysis of 29 studies that included more
than 4,800 patients, researchers found that gastrointestinal symptoms are
common and fecal shedding may present an important transmission risk, according
to the report published in JAMA Network Open.
At present it's not known if the virus detected in
patients' stool samples is infectious.
But if it is, a lot of exposure could happen
through a fecal oral route through food handling or in public restrooms - if you
were to use a restroom after someone who was pre-symptomatic or asymptomatic,
you could potentially contract the virus (if it becomes aerosolized).
Researchers included 23 published studies and six
preprint articles, which contained data on a total of 4,805 patients with a
mean age of 52.2 years.
Based on pooled data, the researchers found that
12% of patients showed any GI symptoms, with 7.4% reporting diarrhea and 4.6%
reporting nausea or vomiting.
Eight of the studies reported on fecal testing for
the virus in a total of 407 patients. Viral RNA was detected in feces in 40.5%
of the patients. Under electron microscopy, two stool samples (1.3%) showed
live virus.
Overall, viral loads in stool samples were lower
than in respiratory samples (range, 550 copies per mL to 1.21 × 105 copies per
mL versus 641 copies per mL to 1.34 × 1011 copies per mL).
"It's a basic science question: is the virus
coming out infectious? Will it survive the acidity of the stomach and infect
the intestines?"
Unlike the norovirus, say, SARS-CoV-2 has an
envelope of lipid covering it. That lipid layer makes the virus more
susceptible to stomach acid.
SOURCE: https://bit.ly/3hp8UDZ JAMA Network Open,
online June 11, 2020.
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