INFECTION OF GASTRO-INTESTINAL TRACT BY SARS-CoV-2 AND ITS POTENTIAL FOR FAECAL-ORAL TRANSMISSION: A LITERATURE REVIEW

Abstract

Context: SARS-CoV-2, has already affected more than 180 countries. 3,175,207 confirmed cases and 224,173 deaths due to the disease were reported worldwide till 1st May 2020. WHO has declared it a Public Health Emergency of International Concern. Aims: To present information from worldwide literature on infection of gastro-intestinal tract by SARS-CoV-2 and its potential for faecal-oral transmission. Material and Methods: Literature search was carried out using Google Scholar and PubMed in 3rd week of April, 2020. Search terms used were “SARS-CoV-2” or “COVID-19” or “New Coronavirus” or “Coronavirus” in title and “Transmission” or “Faecal” or “Oral” anywhere in the article. Studies from the year 2019 to 2020 published in “English” language were included in the search. Results: 15 studies were found relevant and were included in the review. Studies reported that SARS-CoV-2 infects and replicates in gastro-intestinal tract and manifests enteric symptoms. Viral RNA is excreted in stool. Fecal samples were found to be positive for the viral RNA for many days even after respiratory samples become negative. Virus has been detected in anal swabs and live virus could be successfully isolated from stool specimen. The virus was also reported to be viable in the environment for many days. Conclusions: SARS-CoV-2 can potentially be transmitted by faecal-oral route. The transmission can occur even after respiratory symptoms subside and respiratory tract samples test negative for the virus. Appropriate policy response is needed for awareness, testing, discharge and quarantine of patients to prevent spread of the disease. Keywords--SARS-CoV-2, Coronavirus Outbreak, COVID-19, New Coronaviru