Investigation of SARS-CoV-2 faecal shedding in the community: a prospective household cohort study (COVID-LIV) in the UK

Vaselli, Natasha Marcella, Setiabudi, Wega, Subramaniam, Krishanthi, Adams, Emily ORCID: https://orcid.org/0000-0002-0816-2835, Turtle, Lance, Iturriza-Gómara, Miren, Solomon, Tom, Cunliffe, Nigel A., French, Neil, Hungerford, Daniel, Turtle, Lance, Hungerford, Daniel, Subramaniam, Krishanthi, Vivancos, Roberto, Gabbay, Mark, Buchan, Iain, Carrol, Enitan D., Iturriza-Gómara, Miren, Solomon, Tom, Cunliffe, Nigel A., Adams, Emily ORCID: https://orcid.org/0000-0002-0816-2835, Gamble, Carrol, Crossley, Lynnette, Joseph, Neil, Setiabudi, Wega, Vaselli, Natasha Marcella, Wilton, Moon, Troughton, Lee D., Kilada, Samantha, Abba, Katharine, Simpson, Victoria, Tulloch, John S. P., Goodwin, Lynsey, Daws, Rachael, Forootan, Shiva Seyed, Dobson, Susan, Press, Rachel, Spaine, Vida, Hands, Lesley, Bradfield, Kate, McNally, Carol, Moitt, Tracy, Balabanova, Silviya, Donohue, Chloe, Finnetty, Lynsey, Marsh, Laura, Greenhalf, William, Naisbitt, Dean J., Shaw, Victoria E., Aston, Stephen, Platt, Gareth, Dunn, Christopher, Thomson, Paul J., Ogese, Monday, Hammond, Sean, Adair, Kareena, Farrell, Liam, Gardner, Joshua, Jaruthamsophon, Kanoot, Ali, Serat-E, Lister, Adam, Booth, Laura, Ashworth, Milton, Bullock, Katie, Catterall, Benjamin W. A., Foster, Terry, Lavelle-Langham, Lara, Middleton, Joanna, Reynolds, William, Cass, Emily, Carracedo, Alejandra Doce, Davies, Lianne, Flaherty, Lisa, Oates, Melanie, Maziere, Nicole, Lloyd, Jennifer, Jones, Christopher, Massey, Hannah, Holmes, Anthony, Carlucci, Nicola, Brammah, Vanessa, Ramos, Yasmyn, Allen, Daniel, Armstrong, Jane, Howarth, Debbie, Wilcock, Eve, Lowe, Jenna, Jones, Jayne, Wright, Paula, Slack, Iain, McLaughlin, Simone, Mason, Jessica, Edwards, Thomas, McKeown, Claudia, Hendrick, Elysse, Williams, Chris, Byrne, Rachel, Buist, Kate, Garrod, Gala, Owen, Sophie ORCID: https://orcid.org/0000-0002-0458-2357, Jones, Ashley P. and Gkioni, Efstathia (2021) 'Investigation of SARS-CoV-2 faecal shedding in the community: a prospective household cohort study (COVID-LIV) in the UK'. BMC Infectious Diseases, Vol 21, Issue 1, p. 784.

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Abstract

Background
SARS-CoV-2 is frequently shed in the stool of patients hospitalised with COVID-19. The extent of faecal shedding of SARS-CoV-2 among individuals in the community, and its potential to contribute to spread of disease, is unknown.

Methods
In this prospective, observational cohort study among households in Liverpool, UK, participants underwent weekly nasal/throat swabbing to detect SARS-CoV-2 virus, over a 12-week period from enrolment starting July 2020. Participants that tested positive for SARS-CoV-2 were asked to provide a stool sample three and 14 days later. In addition, in October and November 2020, during a period of high community transmission, stool sampling was undertaken to determine the prevalence of SARS-CoV-2 faecal shedding among all study participants. SARS-CoV-2 RNA was detected using Real-Time PCR.

Results
A total of 434 participants from 176 households were enrolled. Eighteen participants (4.2%: 95% confidence interval [CI] 2.5–6.5%) tested positive for SARS-CoV-2 virus on nasal/throat swabs and of these, 3/17 (18%: 95% CI 4–43%) had SARS-CoV-2 detected in stool. Two of three participants demonstrated ongoing faecal shedding of SARS-CoV-2, without gastrointestinal symptoms, after testing negative for SARS-CoV-2 in respiratory samples. Among 165/434 participants without SARS-CoV-2 infection and who took part in the prevalence study, none had SARS-CoV-2 in stool. There was no demonstrable household transmission of SARS-CoV-2 among households containing a participant with faecal shedding.

Conclusions
Faecal shedding of SARS-CoV-2 occurred among community participants with confirmed SARS-CoV-2 infection. However, during a period of high community transmission, faecal shedding of SARS-CoV-2 was not detected among participants without SARS-CoV-2 infection. It is unlikely that the faecal-oral route plays a significant role in household and community transmission of SARS-CoV-2.

Item Type:	Article
Subjects:	QW Microbiology and Immunology > Viruses > QW 160 Viruses (General). Virology WA Public Health > WA 4 Works on general hygiene WC Communicable Diseases > WC 20 Research (General) WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 505 Viral respiratory tract infections
Faculty: Department:	Biological Sciences > Department of Tropical Disease Biology
Digital Object Identifer (DOI):	https://doi.org/10.1186/s12879-021-06443-7
Depositing User:	Marie Hatton
Date Deposited:	15 Oct 2021 09:18
Last Modified:	15 Oct 2021 09:18
URI:	https://archive.lstmed.ac.uk/id/eprint/19173

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