In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral–fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral–fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
COVID-19 virus infection mainly causes symptoms in the respiratory system, such as coughing and shortness of breath. However, within the spectrum of symptoms, diarrhoea has been identified as a manifestation of disease in the digestive system.
Last February, a study was published which showed the presence of the virus in the faeces of sick patients, which raises the possibility of an alternative route of transmission, the faecal-oral route.
It is possible that within the characteristics of the new Coronavirus is the high resistance to adverse conditions, such as acids and digestive enzymes or transit through the digestive system?