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Cherne MD, Gentry AB, Nemudraia A, Nemudryi A, Hedges JF, Walk H, Blackwell K, Snyder DT, Jerome M, Madden W, Hashimi M, Sebrell TA, King DB, Plowright RK, Jutila MA, Wiedenheft B, Bimczok D. Severe Acute Respiratory Syndrome Coronavirus 2 Is Detected in the Gastrointestinal Tract of Asymptomatic Endoscopy Patients but Is Unlikely to Pose a Significant Risk to Healthcare Personnel. Gastro Hep Adv 2022; 1:844-852. [PMID: 35765598 PMCID: PMC9225937 DOI: 10.1016/j.gastha.2022.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022]
Abstract
Background and Aims Recent evidence suggests that the gut is an additional target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, whether SARS-CoV-2 spreads via gastrointestinal secretions remains unclear. To determine the prevalence of gastrointestinal SARS-CoV-2 infection in asymptomatic subjects, we analyzed gastrointestinal biopsy and liquid samples from endoscopy patients for the presence of SARS-CoV-2. Methods We enrolled 100 endoscopic patients without known SARS-CoV-2 infection (cohort A) and 12 patients with a previous COVID-19 diagnosis (cohort B) in a cohort study performed at a regional hospital. Gastrointestinal biopsies and fluids were screened for SARS-CoV-2 by polymerase chain reaction (PCR), immunohistochemistry, and virus isolation assay, and the stability of SARS-CoV-2 in gastrointestinal liquids in vitro was analyzed. Results SARS-CoV-2 ribonucleic acid was detected by PCR in the colonic tissue of 1/100 patients in cohort A. In cohort B, 3 colonic liquid samples tested positive for SARS-CoV-2 by PCR and viral nucleocapsid protein was detected in the epithelium of the respective biopsy samples. However, no infectious virions were recovered from any samples. In vitro exposure of SARS-CoV-2 to colonic liquid led to a 4-log-fold reduction of infectious SARS-CoV-2 within 1 hour (P ≤ .05). Conclusion Overall, the persistent detection of SARS-CoV-2 in endoscopy samples after resolution of COVID-19 points to the gut as a long-term reservoir for SARS-CoV-2. Since no infectious virions were recovered and SARS-CoV-2 was rapidly inactivated in the presence of colon liquids, it is unlikely that performing endoscopic procedures is associated with a significant infection risk due to undiagnosed asymptomatic or persistent gastrointestinal SARS-CoV-2 infections.
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Affiliation(s)
- Michelle D Cherne
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Andrew B Gentry
- Department of Gastroenterology, Bozeman Health Deaconess Hospital, Bozeman, Montana
| | - Anna Nemudraia
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Artem Nemudryi
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Jodi F Hedges
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Heather Walk
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Karlin Blackwell
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Deann T Snyder
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Maria Jerome
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Wyatt Madden
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
- Rollins School of Public Heath, Emory University, Atlanta, Georgia
| | - Marziah Hashimi
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - T Andrew Sebrell
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - David B King
- Department of Clinical Research, Bozeman Health Deaconess Hospital, Bozeman, Montana
| | - Raina K Plowright
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Mark A Jutila
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Blake Wiedenheft
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Diane Bimczok
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
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