Clinical Features of Stool SARS-CoV-2 RNA Positive in 137 COVID-19 Patients in Taizhou, China

Background: New coronavirus pneumonia (COVID-19) outbreak and caused global human respiratory tract infections since 2019, however, the pattern of SARS-CoV-2 intestinal tract infections is not well understood. Methods: The virological and epidemiological researches prompted us to speculate that the human intestinal tract may serve as a supplementary route to acquire SARS-CoV-2 infection. By identifying the evidence of virus intestinal infection in 343 stool specimen and identifying the evidence of virus respiratory infection in 575 throat swabs samples in 137 clinical patient who were confirmed diagnosis with COVID-19 subsequently. Results: As the largest stool samples and the longest monitoring time so far, our study demonstrated that in spite of the virus harbour in the respiratory tract earlier than intestinal tract as 106 patients (77%) showed the first throat swab virus positive and only 22 patients (16%) showed the first stool virus positive in the first 10 days after their disease onset respectively, however, SARS-CoV-2 would harbour in the both respiratory tract and intestinal tract for 10-14 days. In addition, many patients appeared stool RNA positive when their swab RNA had turn negative and we suggested that both throat swabs and stool specimens are needed to absolutely confirm the elimination of the SARS-CoV-2. Conclusions: We addressed a scientific clinical evidence for the implementation of effective prevention measures to halt the continuing COVID-19 epidemic. Funding Statement: This work is funded by China National Natural Youth Science Foundation (81802078), Zhejiang Province Analysis Test Project Foundation (2018C37032), Zhejiang Province Public Welfare Research Foundation (GF20H200021), Zhejiang Provincial Department of Medicine and Health Foundation ( 2018KY912/2019RC315/2019323341/2020KY371), Enze Medical Center (Group) Scientific Research Foundation(18EZA06/15EZC2) and Luqiao Science and Technology Bureau Foundation (2017A23005). Declaration of Interests: All authors declare no competing interests. Ethics Approval Statement: This study was approved by the Ethics Committee of Enze Medical Center (Group). Written informed consent was obtained from all patients enrolled into this study or their legal guardians.