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Covid-19 Patients May Have Prolonged Gut Infection
Published on: 2020-09-08
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gut 01Covid-19 patients have active and prolonged gut viral infection, even in the absence of gastrointestinal symptoms, scientists in Hong Kong showed.

The coronavirus may continue to infect and replicate in the digestive tract after clearing in the airways, researchers at the Chinese University of Hong Kong said in a statement Monday. The findings, published in the medical journal GUT, have implications for identifying and treating cases, they said.

SARS-CoV-2 spreads mainly through respiratory droplets -- spatters of virus-laden discharge from the mouth and nose, according to the World Health Organization. Since the first weeks of the pandemic, however, scientists in China have said infectious virus in the stool of patients may also play a role in transmission.

Cells containing coronavirus seen through a microscopeCells containing coronavirus seen through a microscope

A February study of 73 patients hospitalized with the coronavirus in China’s Guangdong province found more than half tested positive for the virus in their stool.

The Hong Kong scientists studied stool samples from 15 patients to better understand the virus’s activity in the gastrointestinal tract. They found active gut infection in seven patients, some of whom had no nausea, diarrhea or other digestive symptoms. Three patients continued to display active viral infection as long as six days after their respiratory samples tested negative for Covid-19.

A worker wearing personal protective equipment holds a tray containing unlabeled ampoules of the Covid 19 vaccineA worker wearing personal protective equipment holds a tray containing unlabeled ampoules of the Covid-19 vaccine

The finding “highlights the importance of long-term coronavirus and health surveillance and the threat of potential fecal-oral viral transmissions,” Siew Chien Ng, associate director of the university’s Centre for Gut Microbiota Research, said in the statement.

Treatments that modulate the composition and functionality of the gut microbiome should be explored, according to Ng. The gut bacteria of patients who were particularly infectious showed a loss of protective microbes and a proliferation of disease-causing ones.

部分新冠患者康复后粪便内病毒仍具传染性

香港中文大学(中大)医学院7日在记者会上宣布,首次证实新冠肺炎患者即使无肠胃不适症状,肠道及粪便内都会发现活跃新冠病毒;部分患者康复后,粪便内病毒仍具传染性及可复制性。同日,港中大新冠病毒检测中心成立,致力为婴幼儿作粪便检测,旨在切断隐性传播链。

港中大医学院今年2月至4月跟进本地15名患者,发现近半患者即使未出现肠胃不适,粪便样本内仍可发现活跃新冠病毒。当中,有3名患者在呼吸道样本已侦测不到病毒6日后,验出粪便样本中仍含有具传染性及可复制的新冠病毒。而粪便样本病毒传染性较高者,肠道微生态有较多病原体,及较少能制造短链脂肪酸的益生菌。研究认为,患者出院后须作健康监测,避免病毒经粪便传播。而清除患者肠道内的病毒及改变肠道微生态,或将成为治疗新冠病毒的新方向。

另外,港中大医学院自今年3月底起,已开始为机场抵港儿童及有需要人士提供免费粪便检测服务。截至8月底,共计检测逾2000样本,成功识别6名儿童确诊患者,比率为0.28%。

港中大医学院院长及肠道微生物群研究中心主任陈家亮指,深喉唾液检测,往往未必有阳性反应,反而粪便样本中已多次验出病毒,相信粪便是导致社区传播的高风险因素之一。且许多婴幼儿患者并无病征,但粪便中病毒量较成人高出多倍,病毒水平相当于成人呼吸道样本,病毒排放时间亦较长。“粪便样本易收集、准确度高,适合婴幼儿及身体不适合做鼻腔或咽喉采样之人士。”他并透露,美国食品药物管理局等机构正与中大进行接洽,会进一步了解粪便检测细节及安排。

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