A prospective cohort study of the presence of SARS-CoV-2 in clinical samples from multiple bodily sites: implications for transmission routes of COVID-19

Meixian Liu, Huimin Huang, Xiqing Bian, Zhi-Jia Zheng, Na Li, Baoqing Sun, Jian-Lin Wu
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Abstract

Abstract Objective: The coronavirus disease 2019 (COVID-19) epidemic resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has still spread globally. The occurrence of the Delta variant, which is more infectious and spreads faster than earlier forms of the virus that causes COVID-19, makes infection prevention more challenging. Therefore, this study aimed to gain a comprehensive insight into the transmission routes of SARS-CoV-2 for curbing the propagation of SARS-CoV-2 in human populations. Methods: We studied a prospective cohort of 576 patients admitted consecutively to the First Affiliated Hospital of Guangzhou Medical University from January 21 to June 8, 2020. These patients were chosen based on their similar clinical phenotypes or imaging findings. There were 21 (3.6%) laboratory-confirmed COVID-19 patients (16 severe and 5 mild cases) and 555 non-COVID-19 patients. The antibody response and routes and duration of viral shedding were systematically evaluated in serial clinical specimens. Moreover, SARS-CoV-2 RNA was also detected in a mouth rinse, urine, and tear samples. This study was approved by the Medical Ethical Committee of The First Affiliated Hospital of Guangzhou Medical University (approval No. 2020-77). Results: SARS-CoV-2 mainly existed in sputum, nasal and throat swabs, and feces samples. Virus latency was longer in sputum and feces samples than in nasopharyngeal samples. IgG antibody response in respiratory samples was related to disease severity. Although droplets and aerosols are the major transmission routes for COVID-19, covert routes of transmission from asymptomatic patients, contaminated surfaces, and wastewater are also of interest. Conclusion: Our findings provide a solid foundation for developing prophylactic measures against SARS-CoV-2.
来自多个身体部位的临床样本中存在SARS-CoV-2的前瞻性队列研究:对COVID-19传播途径的影响
摘要目的:由严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)引起的冠状病毒病2019 (COVID-19)疫情仍在全球蔓延。与导致COVID-19的早期病毒形式相比,Delta变体的传染性更强,传播速度更快,这使得感染预防更具挑战性。因此,本研究旨在全面了解SARS-CoV-2的传播途径,以遏制SARS-CoV-2在人群中的传播。方法:对2020年1月21日至6月8日在广州医科大学第一附属医院连续住院的576例患者进行前瞻性队列研究。这些患者是根据他们相似的临床表型或影像学发现来选择的。实验室确诊病例21例(3.6%)(重症16例,轻症5例),非病例555例。在一系列临床标本中系统评估抗体反应、病毒脱落途径和持续时间。此外,在漱口水、尿液和眼泪样本中也检测到SARS-CoV-2 RNA。本研究经广州医科大学第一附属医院医学伦理委员会批准(批准号2020-77)。结果:SARS-CoV-2主要存在于痰液、鼻咽拭子和粪便样本中。病毒在痰和粪便标本中的潜伏期比在鼻咽标本中的潜伏期长。呼吸道样本IgG抗体反应与疾病严重程度相关。虽然飞沫和气溶胶是COVID-19的主要传播途径,但来自无症状患者、受污染表面和废水的隐蔽传播途径也令人感兴趣。结论:本研究结果为制定SARS-CoV-2的预防措施提供了坚实的基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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