Jessica R. Allegretti , MD, MPH

This is an extremely important topic and is something we need to discuss especially now that there is evidence SARs-CoV-2 sheds/can be detected in the stool. I have been asked by several colleagues if FMT as a therapy is on hold but that is not the case currently. Specifically, for providers who use OpenBiome stool, it is important to know there have been no cases of COVID-19 transmitted through FMT reported to date. Also, all OpenBiome material that is in circulation currently was collected prior to Dec. 1, 2019. OpenBiome has already implemented screening of all donors that includes molecular testing for SARs-CoV-2 and screening for COVID-19 risk factors and symptoms per FDA guidance. Currently, stool testing for SARs-Cov-2 is not available, however donors are now being tested via nasopharyngeal swab. Additionally, everything that was collected after Dec. 1, 2019 is in quarantine. Every healthcare provider can feel confident about the material being provided by OpenBiome if they need to perform an FMT. That being said, we are not doing any elective endoscopy around the country for the most part due to lack of personal protective equipment and the dire need for protection for providers performing endoscopic procedures. Therefor few outpatient FMTs are being done currently, at least at my center. If there was a need for an emergent inpatient case, it’s important for providers and patients to know that the material that is in circulation right now is safe for use. This doesn’t apply to centers that are doing their own screening, I can’t speak to that because I don’t know what procedures have been put in place at individual centers with their own stool banks, but the current recommendation from FDA guidance is to not use material collected after Dec 1, 2019 until proper testing and screening protocols are put into place.