Gastro Hep Adv . SARS-CoV-2 is detected in the gastrointestinal tract of asymptomatic endoscopy patients but is unlikely to pose a significant risk to healthcare personnel

[tetano]

Gastro Hep Adv


. 2022 Jun 24.
doi: 10.1016/j.gastha.2022.06.002. Online ahead of print.
SARS-CoV-2 is detected in the gastrointestinal tract of asymptomatic endoscopy patients but is unlikely to pose a significant risk to healthcare personnel


Michelle D Cherne ¹ , Andrew B Gentry ² , Anna Nemudraia ¹ , Artem Nemudryy ¹ , Jodi F Hedges ¹ , Heather Walk ¹ , Karlin Blackwell ¹ , Deann T Snyder ¹ , Maria Jerome ¹ , Wyatt Madden ^{1 3} , Marziah Hashimi ¹ , T Andrew Sebrell ¹ , David B King ² , Raina K Plowright ¹ , Mark A Jutila ¹ , Blake Wiedenheft ¹ , Diane Bimczok ¹



Affiliations

• PMID: 35765598
• PMCID: PMC9225937
• DOI: 10.1016/j.gastha.2022.06.002

Abstract

Background and aims: Recent evidence suggests that the gut is an additional target for SARS-CoV-2 infection. However, whether SARS-CoV-2 spreads via gastrointestinal secretions remains unclear. To determine the prevalence of gastrointestinal SARS-CoV-2 infection in asymptomatic subjects, we analyzed gastrointestinal biopsy and liquid samples from endoscopy patients for the presence of SARS-CoV-2.
Methods: We enrolled 100 endoscopic patients without known SARS-CoV-2 infection (cohort A) and 12 patients with a previous COVID-19 diagnosis (cohort B) in a cohort study performed at a regional hospital. Gastrointestinal biopsies and fluids were screened for SARS-CoV-2 by PCR, immunohistochemistry and virus isolation assay, and the stability of SARS-CoV-2 in gastrointestinal liquids in vitro was analyzed.
Results: SARS-CoV-2 RNA was detected by PCR in the colonic tissue of 1/100 patients in cohort A. In cohort, B, three colonic liquid samples tested positive for SARS-CoV-2 by PCR, and viral nucleocapsid protein was detected in the epithelium of the respective biopsy samples. However, no infectious virions were recovered from any samples. In vitro exposure of SARS-CoV-2 to colonic liquid led to a 4-log fold reduction of infectious SARS-CoV-2 within 1 hour (P ≤ 0.05).
Conclusions: Overall, the persistent detection of SARS-CoV-2 in endoscopy samples after resolution of COVID-19 points to the gut as a long-term reservoir for SARS-CoV-2. Since no infectious virions were recovered and SARS-CoV-2 was rapidly inactivated in the presence of colon liquids, it is unlikely that performing endoscopic procedures is associated with a significant infection risk due to undiagnosed asymptomatic or persistent gastrointestinal SARS-CoV-2 infections.

Keywords: COVID-19, coronavirus disease 2019; CT, cycle threshold; E gene, envelope gene; Endoscopy; GI, gastrointestinal; N gene, nucleocapsid gene; NP, nucleocapsid protein; PFU, plaque-forming units; SARS-CoV-2; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; colonic liquid; qRT-PCR, quantitative reverse transcription polymerase chain reaction; transmission risk.