SARS-CoV-2 genomes persist in GI tract following infection resolution
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SAN DIEGO — The discovery of SARS-CoV-2 genomes in endoscopy samples of patients who recovered from COVID-19 suggests that the gut serves as a reservoir for the virus, according to research presented at Digestive Disease Week 2022.
“SARS-CoV-2, or COVID, is mostly a respiratory tract infection, but in about 30% of patients you also see digestive symptoms such as diarrhea and vomiting or nausea,” Diane Bimczok, PhD, associate professor of microbiology and immunology at Montana State University, said. “It's been shown in a number of studies there is also fecal shedding of SARS-CoV-2 RNA, and this frequently lasts for longer than we normally see shedding from the respiratory tract, indicating that the gastrointestinal tract is a reservoir for long-term viral persistence.”
Between April 2020 and February 2021, 112 patients aged 19 to 70 years old with either no previous SARS-CoV-2 exposure (n = 100) or who had recovered from SARS-CoV-2 infection (n = 12) underwent elective endoscopic procedures.
Following standard bowel preparation protocols, Bimczok and colleagues collected liquids and biopsies from the colon, ileum, duodenum and stomach of participants and analyzed samples for SARS-CoV-2 infection. Positive polymerase chain reaction test results were then analyzed for the presence of infectious virus using plaque assays. Researchers further assessed whether endoscopic colonic liquids could inactivate SARS-CoV-2.
Among patients with a previous history of SARS-CoV-2, 25% had colonic fluid samples test positive for up to 5 months following the resolution of their symptoms. Researchers did not detect replication-competent virus in any of the tissue or liquid samples, and in vitro treatment of SARS-CoV-2 with colonic liquid showed the virus was completely inactive after 24 hours; however, at the 10-minute and 1-hour timepoint, viral inactivation varied.
In addition, one biopsy from a patient with no known exposure to SARS-CoV-2 tested positive via PCR, which is consistent with the large proportion of asymptomatic patients in the United States.
“We can detect SARS-CoV-2 protein and viral RNA in the gastrointestinal tract of all asymptomatic endoscopy patients, but we do not think that there's a significant risk to health care personnel during endoscopy,” Bimczok concluded. “Viral RNA and protein are present in some asymptomatic patients, and they can persist long-term. There’s no evidence that infectious viruses in the tissue are shed from the colonic liquids.”
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Gentry AB, et al. Abstract 651. Presented at: Digestive Disease Week; May 21-24, 2022; San Diego (hybrid meeting).
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