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Although Covid-19 is a respiratory disease, a new study suggests that the coronavirus can infect the intestinal tract for months after clearing the virus from the lungs.
Research published in the journal Med shows that about 1 in 7 Covid-19 patients continued to shed genetic remnants of the virus in their stool at least four months after their initial diagnosis, long after they stopped shedding the virus from their pathways. respiratory.
“We found that people who had cleared their respiratory infection, meaning they no longer tested positive for SARS-CoV-2 in their airways, continued to shed SARS-CoV-2 RNA in their stool,” he says. Ami Bhatt, from Stanford University (USA)
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“And those people, in particular, had a high incidence of gastrointestinal symptoms.”
A long-term infection of the intestine could also contribute to prolonged Covid-19 symptoms in some people, according to Bhatt.
“Persistent Covid-19 could be the consequence of an ongoing immune reaction to SARS-CoV-2, but it could also be that we have people who have persistent infections that are hide in niches other than the respiratory tract», explica Bhatt.
For this study, the research team took advantage of a clinical trial launched in May 2020 at Stanford to test a potential treatment for mild Covid-19 infection. More than 110 patients were monitored for the evolution of their symptoms, and regular stool samples were collected as part of an effort to track their viral spread.
Many other studies have focused on viral shedding in patients with severe cases of Covid, but this is the first to assess the presence of viral RNA in fecal samples collected from people with mild to moderate Covid.
About half of the patients (49%) had traces of Covid RNA in their stool during the first week after diagnosis. But four months after diagnosis, when there was no more Covid left in their lungs, nearly 13% of patients were still shedding viral RNA in their stool.
And about 4% were still shedding viral RNA in their stool seven months after their initial diagnosis, the researchers found.
Bhatt however claims that the RNA was genetic remnants of the coronavirus and not an actual live virus, so it is unlikely that a person’s stool is contagious.
“While there have been isolated reports of people being able to isolate live SARS-CoV-2 virus from feces, I think that’s probably much less common than being able to isolate live virus from the respiratory tract,” Bhatt said. “I don’t think our study suggests that there is much fecal-oral transmission».
But the persistent presence of Covid in the intestine suggests a potential influence for long-term disease, he acknowledges.
“SARS-CoV-2 could remain in the intestine or even in other fabrics over a longer period of time than in the respiratory tract, and there it can basically continue to trigger our immune system and induce some of these long-term consequences,” says Bhatt.
Long-Covid has become such an established problem that many major medical centers have set up their own Long-Covid clinics to try to screen for symptoms and potential treatments, says William Schaffner, medical director of the National Foundation for Infectious Diseases.
“A very significant proportion of people who recover acutely from Covid, however, have persistent symptoms, and these can involve a range of different organ systems,” Schaffner says.
“These data add to the notion that cells in the gut may be involved in viral infection by Covid, and could potentially contribute to some of the symptoms. (abdominal pain, nausea, a kind of intestinal discomfortl) that may be an aspect of Long Covid,” he said.
Bhatt said the findings also have public health implications for predicting emerging Covid outbreaks by testing a community’s sewage for evidence of the virus.
“If, as they say, about 4% of people seven or eight months later are still excreting viral remains in their stool, the evaluation of the density of new infections in a community is complicated,” says Schaffner. “That’s another thing we need to keep in mind.”
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