Coronavirus persists in sputum, feces weeks after pharyngeal samples turn from positive to negative

  • Ann Intern Med

  • von Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • The novel coronavirus (SARS-CoV-2) persists on fecal and sputum samples up to 39 days after COVID-19-infected patients' pharyngeal samples convert from positive to negative, according to a small study from China.

Why this matters

  • The clinical significance of this finding, i.e., whether the positive samples are sufficient to transmit COVID-19, is unknown.
  • More research is strongly warranted.
  • In the meantime, social distancing of discharged COVID-19 patients may be necessary.

Study design

  • Convenience sample of 22 COVID-19 patients whose pharyngeal samples converted from positive to negative and who were released from the hospital.
  • Discharge required 4 criteria:
    • Being afebrile for >3 days.
    • Resolution of respiratory symptoms.
    • Substantial improvement of chest CT.
    • 2 consecutive respiratory samples negative ≥24 hours apart.
  • Funding: Beijing Science and Technology Commission.

Key results

  • All but 2 of 22 patients had mild pneumonia; the 2 had severe and critical illness.
  • 18/22 were aged 15-65 years.
  • 545 specimens were collected from the 22 patients, including 262 sputum samples and 74 fecal samples.
  • Using real-time reverse-transcriptase-quantitative PCR, sputum remained positive for SARS-CoV-2 up to 39 days and feces remained positive for 13 days after pharyngeal samples converted from positive to negative.

Limitations

  • Convenience sample.
  • Small numbers, no controls.