tetano
Editor, Senior Moderator
Epidemiol Infect
. 2024 Nov 12:152:e138.
doi: 10.1017/S0950268824001481. Oro-faecal transmission of SARS-CoV-2: A systematic review of studies employing viral culture from gastrointestinal and other potential oro-faecal sources and evidence for transmission to humans
Sara Gandini[SUP] 1 [/SUP], John Conly[SUP] 2 [/SUP], Elizabeth A Spencer[SUP] 3 [/SUP], David Evans[SUP] 4 [/SUP], Elena C Rosca[SUP] 5 [/SUP], Jon Brassey[SUP] 6 [/SUP], Susanna Maltoni[SUP] 7 [/SUP], Igho Onakpoya[SUP] 3 [/SUP], Annette Plüddemann[SUP] 3 [/SUP], Tom Jefferson[SUP] 3 [/SUP], Carl Heneghan[SUP] 3 [/SUP]
Affiliations
The extent to which the oro-faecal route contributes to the transmission of SARS-CoV-2 is not established.We systematically reviewed the evidence on the presence of infectious SARS-CoV-2 in faeces and other gastrointestinal sources by examining studies that used viral culture to investigate the presence of replication-competent virus in these samples. We conducted searches in the WHO COVID-19 Database, LitCovid, medRxiv, and Google Scholar for SARS-CoV-2 using keywords and associated synonyms, with a search date up to 28 November 2023.We included 13 studies involving 229 COVID-19 subjects - providing 308 faecal or rectal swab SARS-CoV2 reverse transcription-polymerase chain reaction (RT-PCR)-positive samples tested with viral culture. The methods used for viral culture across the studies were heterogeneous. Three studies (two cohorts and one case series) reported observing replication-competent SARS-CoV-2 confirmed by quantitative RT-PCR (qPCR) and whole-genome sequencing, and qPCR including appropriate cycle threshold changes. Overall, six (1.9%) of 308 faecal samples subjected to cell culture showed replication-competent virus. One study found replication-competent samples from one immunocompromised patient. No studies were identified demonstrating direct evidence of oro-faecal transmission to humans.Our review found a relatively low frequency of replication-competent SARS-CoV-2 in faecal and other gastrointestinal sources. Although it is biologically plausible, more research is needed using standardized cell culture methods, control groups, adequate follow-up, and robust epidemiologic methods, including whether secondary infections occurred, to determine the role of the oro-faecal route in the transmission of SARS-CoV-2.
Keywords: Covid-19; SARS-CoV-2; oro-faecal; systematic review; viral culture.
. 2024 Nov 12:152:e138.
doi: 10.1017/S0950268824001481. Oro-faecal transmission of SARS-CoV-2: A systematic review of studies employing viral culture from gastrointestinal and other potential oro-faecal sources and evidence for transmission to humans
Sara Gandini[SUP] 1 [/SUP], John Conly[SUP] 2 [/SUP], Elizabeth A Spencer[SUP] 3 [/SUP], David Evans[SUP] 4 [/SUP], Elena C Rosca[SUP] 5 [/SUP], Jon Brassey[SUP] 6 [/SUP], Susanna Maltoni[SUP] 7 [/SUP], Igho Onakpoya[SUP] 3 [/SUP], Annette Plüddemann[SUP] 3 [/SUP], Tom Jefferson[SUP] 3 [/SUP], Carl Heneghan[SUP] 3 [/SUP]
Affiliations
- PMID: 39529596
- DOI: 10.1017/S0950268824001481
The extent to which the oro-faecal route contributes to the transmission of SARS-CoV-2 is not established.We systematically reviewed the evidence on the presence of infectious SARS-CoV-2 in faeces and other gastrointestinal sources by examining studies that used viral culture to investigate the presence of replication-competent virus in these samples. We conducted searches in the WHO COVID-19 Database, LitCovid, medRxiv, and Google Scholar for SARS-CoV-2 using keywords and associated synonyms, with a search date up to 28 November 2023.We included 13 studies involving 229 COVID-19 subjects - providing 308 faecal or rectal swab SARS-CoV2 reverse transcription-polymerase chain reaction (RT-PCR)-positive samples tested with viral culture. The methods used for viral culture across the studies were heterogeneous. Three studies (two cohorts and one case series) reported observing replication-competent SARS-CoV-2 confirmed by quantitative RT-PCR (qPCR) and whole-genome sequencing, and qPCR including appropriate cycle threshold changes. Overall, six (1.9%) of 308 faecal samples subjected to cell culture showed replication-competent virus. One study found replication-competent samples from one immunocompromised patient. No studies were identified demonstrating direct evidence of oro-faecal transmission to humans.Our review found a relatively low frequency of replication-competent SARS-CoV-2 in faecal and other gastrointestinal sources. Although it is biologically plausible, more research is needed using standardized cell culture methods, control groups, adequate follow-up, and robust epidemiologic methods, including whether secondary infections occurred, to determine the role of the oro-faecal route in the transmission of SARS-CoV-2.
Keywords: Covid-19; SARS-CoV-2; oro-faecal; systematic review; viral culture.