The University of Louisville Journal of Respiratory Infections


Introduction: SARS-CoV-2 has been strongly associated with respiratory illnesses however the SARS-CoV-2 infection of the gastrointestinal tract is not fully clear. We examined the frequency of positive stool SARS-CoV-2 RT-PCR in COVID-19 patients, duration of the stool viral shedding after the viral clearance of the respiratory samples and its association with gastrointestinal symptoms

Methods: We did a search in PubMed and Google Scholar of studies published in the English language before June 30th, 2020. Search queries included: “COVID-19”, “SARS-CoV-2”, and “stool SARS-CoV-2 RT-PCR”. We excluded studies with less than 8 patients from our review.

Results: Among the 707 patients who had respiratory samples positive for SARS-CoV-2, 361 (51%) patients tested positive through stool SARS CoV-2 RT-PCR. From the 198 patients who tested positive for SARS-CoV-2 in stool, 101 (51%) patients continued testing positive after respiratory samples were negative through SARS-CoV-2 RT-PCR. The longest duration of positive SARS-CoV-2 in stool was 48 days and 33 days after the negative upper respiratory samples. Out of 200 patients who had positive fecal PCR for SARS-CoV-2, 95 patients (47.5%) had at least one gastrointestinal manifestation.

Conclusions: About a half of COVID-19 patients had positive stool SARS-CoV-2 RT-PCR and 51% of patients had positive stool SARS CoV-2 RT-PCR after the respiratory samples became negative for SARS-CoV-2 RT-PCR. At least one GI symptom was reported in 47.5% of patients with a positive stool SARS-CoV-2 RT-PCR.


The author(s) received no specific funding for this work



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