Study: COVID-19 Is Also Spread by Fecal-Oral Route -- Like SARS, COVID-19 may induce liver damage

[LovingA2andMI]

"New research from China indicates that the novel coronavirus is also spread by fecal-oral transmission, not just by respiratory droplets or environmental contact.

Hong Shan, MD, PhD, of Fifth Affiliated Hospital, Sun Yat-sen University, in Zhuhai, Guangdong Province, and colleagues noted that the gastrointestinal tract is a welcoming environment for the virus, also known as severe acute respiratory syndrome (SARS) CoV-2. "Our immunofluorescent data showed that the ACE2 protein, which has been proved to be a cell receptor for SARS-CoV-2, is abundantly expressed in the glandular cells of gastric, duodenal, and rectal epithelia, supporting the entry of SARS-CoV-2 into the host cell," the team wrote.

Among the key findings of the study, published online in Gastroenterology:

A significant portion of coronavirus patients experience diarrhea, nausea, vomiting, and/or abdominal discomfort before the onset of respiratory symptoms

Viral gastrointestinal infection and potential fecal-oral transmission can last even after viral clearance from the respiratory tract.

The study looked at 73 patients hospitalized for possible COVID-19 and tested from February 1 to 14, 2020. Testing included serum, nasopharyngeal, and oropharyngeal swabs, as well as urine, stool, and tissue samples in accordance with China Disease Control and Prevention guidelines.

A total of 39 patients (53.4%; 25 males and 14 females), tested positive for fecal SARS-CoV-2 RNA. The age of patients with positive RNA in stool ranged from 10 months to 78 years, and the duration of stool positivity ranged from 1 to 12 days. Furthermore, the stool of 17 patients (23.3%) remained positive even after respiratory samples tested negative.

Intracellular staining of viral nucleocapsid protein in gastric, duodenal, and rectal epithelia showed that the virus infected glandular epithelial cells in these areas, the researchers reported. "The continuous positive detection of the viral RNA from feces suggests that the infectious virions are secreted from the virus-infected gastrointestinal cells."

"Therefore, we strongly recommend that rRT-PCR [reverse transcriptase polymerase chain reaction] testing for SARS-CoV-2 from feces should be performed routinely in SARS-CoV-2 patients, and Transmission-Based Precautions for hospitalized SARS-CoV-2 patients should continue if feces tests positive by rRT-PCR testing," Shan and co-authors advised.

Asked for his perspective, Douglas A. Corley, MD, PhD, of Kaiser Permanente San Francisco Medical Center and the University of California San Francisco, who was not involved with the research, told MedPage Today: "A better understanding of how this virus is transmitted is key to preventing its spread. These observations may also help in improving how the disease is diagnosed through testing for the presence of virus in the stool of patients suspected of harboring this virus."

https://www.medpagetoday.com/infectiousdisease/covid19/85315

Excuse me in advance -- while this is a rant....

KNEW IT DAMN IT!!!

In Mid-February, I developed the worst stomach virus (which I thought was stomach flu) ever. Felt like my stomach was literally falling out. Ran to CVS and obtain Imodium for the stomach, took my spouse Tylenol for the fever which was over 100.3 degrees. Did not eat for three days. Still felt like crap but went to work on Monday as I was one month and a half into my new job. That Monday, the spouse got the same crap but not the fever. His went on for four days straight as he did not take the Imodium. Three days before the onset of my issues was at a meeting with a lady who looked truly sick as a dog (for a lack of better words). I sat two seats from her and there was seven people in total in a half moon seating arrangement.

*I got sick
*The guy sitting next to her got sick.
*The lady that sat a seat away from me got sick and was out for 10 days after (she has asthma).

I had two breathing difficulty episodes two weeks and one-half after this. Had to get an inhaler (p.s. I DON'T have asthma) and use it. Week post 5 from all of this - I was FINALLY able to go to a drive-thru testing facility as I work for a health care provider/PCP. Then, I test Negative -- however, this is 5 weeks from when all of this happened.

I'm PISSED that the media keeps saying the same shit (Fever, Breathing Difficulty) and NEVER METHOD SEVERE DIARRHEA, VOMITING, ABDOMINAL DISCOMFORT and/or FEVER at the same time. So many people are being missed. So many people are dying and might die because all the focus is on too damn centered on certain symptoms and not broad enough.

WOW --- this is quite a moment. I am truly blessed and lucky I did not die and feel so bad for others that have..... But...what about my liver? What is the long term impacts on that.

[mr_lebowski]

1. No offense but the flu works like that as well ...

Hard to know what you may have had ... I definitely wouldn't conduct my business as though I was sure I'd already had COVID-19, absent proof.

I figure you won't, but I'm just sayin' ...

Maybe there will be antibody tests soon, that seems like it'd be helpful in your (and many others I'm sure) case.

[LovingA2andMI]

5. None Taken....

But I never had stomach upset with a fever like that before in my lifetime. Also, I do still indeed plan on taking every precaution available as at this point I don't believe a word most media and especially the White House, has to say about COVID-19.

[PoindexterOglethorpe]

2. For what it's worth, there's no such thing as stomach flu.

We tend to use that term for various kinds of upset stomach things.

Influenza is a very specific disease. It doesn't exist as a stomach flu.

Covid-19 is a totally different disease, caused by a totally different virus.

As to your other concerns, yeah, it is beginning to look as though this virus might be leaving behind serious long-term health issues.

Maybe this will finally reduce human population to sustainable levels?

[Meowmee]

3. I have it now, but nasal oral test was neg but I am sure it is a false neg

I have double light viral pneumonia now, low fever, diarrhea, headache etc. cough and terrible back pain etc. I am stable at home. At the field hospital they did ask me about gastro symptoms too. I started out with rapid swelling in my throat which resolved quickly and then bad diarrhea all day and a bad headache before the respiratory stuff. I thought it was a migraine since I often get that with migraines. I had heard sars cov 1 was transmitted fecally as well.

[LovingA2andMI]

4. Interesting....

We both had headaches with the diarrhea. Also, the lady who was sick at the meeting -- wrote back at a later time that she apologized for coming to the meeting sick. She said the next day, she had to go to the E.R. were they diagnosed her with Bicameral pneumonia--- another symptoms of COVID-19.

Take care, and get rest. You will be in my prayers for wellness.

[Meowmee]

6. I have it in both lungs too

My doc said x ray looks like covid type viral pneumonia-deep in lungs. But it is light. I am doing breathing exercises and as much activity as I can to help my lungs. I think it is helping. That is good you did not get pneumonia. I can tell my body is fighting this hard, I am doing my best. Sometimes it feels like a tight band around my chest. Today was better, but I was coughing more but not as much tightness. Thanks😊

[LovingA2andMI]

7. Yea....

We are blessed. Former 18 year smoker here.

Meanwhile, do you have mucinex? If so, that might help break up the mucus and open up the membranes. Walk around in your home as much as you can tolerate. It helps exercise your lung muscles. Also, if you can either order or have someone door step you some Zinc supplement -this might provide some comfort.

Will keep you in my prayers for sure and PLEASE stay in touch. VIRTUAL -

[Meowmee]

8. I took some diabetic tussin

Before I found out it was pneumonia, but it makes me very psycho and dopey, can't take mucinex at all. But I am drinking juice for vit c, started some d again just for now and maybe a zinc spray I have, zinc pills make my stomach worse. Lots of fluids and a humidifier. Yesterday I went for walk which helped and two times breathing ex. Today housework. Cough drops help the cough. I was too tired for the walk but will do one breathing soon. There is not much congestion overall, so weird but some comes out sometimes. The bad pain seems to be better today. Oddly eating and juice helps my pain. Just hope I make it through ok too. 😊 Thanks💕

[SheltieLover]

10. Sending healing vibes your way!

So sorry to hear you are ill! Glad you are able to effectively manage symptoms!

[Meowmee]

18. Thanks Sheltie 💕

The breathing helps a lot and. As much activity as you can do and vit c, i am drinking a few juice packs a day prolly.

[SheltieLover]

20. Yw Meowmee!

I had read when this blew up in NY that ICU docs were reportedly giving therapeutic levels - 1500 mg vit C IV 3-4 times daily to try to help diminish cytokine storm, with some results, so I'm glad you are getting your juice packs! 👏👍

[Meowmee]

23. Yep I heard they were doing it in China too

I can’t take vit c pills etc so the juice is pretty good, each one has 100-180% of daily dose depending on which brand. I wish I could do my own iv because then it prolly wouldn't upset my stomach etc. I do notice the juice and eating help my pain too.

[SheltieLover]

24. So glad you are taking good care!

[LovingA2andMI]

12. You will make it through okay....

Keep up your routine as you're on the right track. Take care and keep in touch. VIRTUAL back at ya!

[Meowmee]

19. Thanks💕😊

[SunSeeker]

9. Well that explains it spreading through bathroom pipes in China & Hong Kong.

https://www.cnn.com/2020/02/12/asia/hong-kong-coronavirus-pipes-intl-hnk/index.html

[SheltieLover]

11. Indeed!

I had read about that too!

This is why I have been avoiding eating lettuce, which I dearly love. And I doubt any medical studies have said that if someone who is infected coughs, sneezes, or breathes on produce and you eat it raw, that infection will follow. It's just another non-medical common sense precaution I have been taking. The virus loves human cells - perhaps gastro as well as lung. 😰

[SunSeeker]

13. And why I tell the family to take their shoes off when they come inside.

It's just common sense and rational in light of what facts we know. And invariable a story comes out supporting what you reasonably deduced from the facts. https://www.healthleadersmedia.com/covid-19/coronavirus-spreads-least-13-feet-travels-shoes-cdc

[SheltieLover]

14. Yes!

Another great point. Thank you for the link.

And here is link to story about MIT research showing droplets can travel up to 27'. Whether viral particles would be viable at that distance remains a mystery, but I'm erring on the side of caution!

[link:https://www.usatoday.com/story/news/health/2020/03/30/coronavirus-social-distancing-mit-researcher-lydia-bourouiba-27-feet/5091526002/|

[MFM008]

15. Ive had a

Touch of that for a week or so, including today.
I should find out the covid test by Weds.
I believe its part of the whole virus.

[LovingA2andMI]

17. If you can find a drive-thru testing location...

Yes.

[OnDoutside]

16. It gives new meaning to Eat shit and die !

[jmowreader]

27. I'm trying not to think that Trump Administration officials are at the highest risk of all

[marlakay]

21. This kind of scares me because last

Few days I have had stomach problems, sick headache, some sneezing (which I thought was allergies) and I have been taking temp and it is slowing climbing.

I don’t have any breathing problems or sore throat which is why I thought it was stomach type flu.

[blitzen]

22. This has been known but not talked about enough for a few weeks, at least...

https://www.businessinsider.com/some-wuhan-coronavirus-patients-have-nausea-vomiting-diarrhea-2020-2

https://www.today.com/health/diarrhea-nausea-or-vomiting-may-be-first-coronavirus-symptoms-some-t177179

[HarlanPepper]

25. I'll ask the question everyone wants to know

Can it be spread by farting?

[jmowreader]

26. Probably, yeah

Today's lesson: buy a new toothbrush, and start brushing your teeth in the kitchen. Microorganisms found in feces can spread in bathroom air a really long way.

[EllieBC]

28. This is why handwashing is so important.

This is how norovirus spreads so easily every year. That’s right. Nasty people don’t wash their hands after wiping their bums or don’t wash them well and then touch all the things. Then you touch all the things and put your hands in your nose or mouth and bam. Welcome to stomach virus hell.

My kid brought home a lovely stomach bug after camping with her Girl Guides Troop back in early February. Lethargy, fever, nausea, lasted for days. Then we all caught a chest cold a week later. Was awful.

Wash your hands, people. Even after there’s a COVID vaccine.

[Nonhlanhla]

29. Hmm, makes me think

I developed a sudden fever one afternoon in mid-February, with stomach cramps etc., and while the fever subsided the next day, I remained nauseous the rest of the week, and I started developing respiratory issues that turned into bronchial pneumonia, with burning lungs and shortness of breath, accompanied by severe diarrhea (I lost nearly 20 lbs in 2 weeks). Even after 3 weeks, although I did not have actual fever, I continued to feel clammy and my temperature would hop up and down a bit from around 96 to nearly 100, and I would get night sweats. I continued having episodes of sore throat for another week or two after that. Also headaches and exhaustion. Makes me wonder, although I realize it could have been anything, and the stomach and respiratory things could have been separate issues.

[Maru Kitteh]

30. As others mentioned there is no "stomach flu" but there is NOROvirus, and that sh#t sucks.

I had noro so bad I was on my couch, hallucinating about wolves in my trees once. You basically expel what feels like every drop of moisture in your entire body by simultaneously puking and shooting pure water out your other side at the same time.

It, was, AWFUL.

Sounds to me like that's what you had.

[MontanaMama]

31. Norovirus is insanely contagious.

My kiddo had it a couple Christmases ago and OMG. I had to sit him on the toilet with a bowl in his lap because it was coming out both ends simultaneously and he could not control it. He was sobbing and I was sobbing and it was awful. I never had seen anything like it. I had never before or since used that much bleach in my house. I don’t know how I didn’t catch it.