key: cord-0761012-hzmcrenk
authors: Jiang, Xuejun; Luo, Mei; Zou, Zhen; Wang, Xu; Chen, Chengzhi; Qiu, Jingfu
title: Asymptomatic SARS‐CoV‐2 infected case with viral detection positive in stool but negative in nasopharyngeal samples lasts for 42 days
date: 2020-04-24
journal: J Med Virol
DOI: 10.1002/jmv.25941
sha: 5bfd362db653744b1e25c697546948fe86d96c15
doc_id: 761012
cord_uid: hzmcrenk

Coronavirus disease 2019 (COVID‐19), caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), has spread rapidly around the world. Currently, the identification of this disease is mainly conducted by using nasopharyngeal swabs([1]), but the presence of SARS‐CoV‐2 RNA in feces of COVID‐19 patients indicates the possibility of transmission via fecal‐oral route([2‐4]). This article is protected by copyright. All rights reserved.

To the editor, Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread rapidly around the world. Currently, the identification of this disease is mainly conducted by using nasopharyngeal swabs [1] , but the presence of SARS-CoV-2 RNA in feces of COVID-19 patients indicates the possibility of transmission via fecal-oral route [2] [3] [4] .

Herein, we report the distinctive clinical characteristics of an asymptomatic case in which SARS-CoV-2 viral nucleotide detection was positive in anal swabs but negative in nasopharyngeal swabs for such a long period (42 days). In this case, an 8-year-old girl (Patient 1) did not show any clinical symptoms, abnormal chest CT image findings or a decreased lymphocyte count. Moreover, she was identified as asymptomatic case on Feb 19 and until now she did not become a confirmed patient with either respiratory or gastrointestinal symptoms. was capable of transmitting the virus to others remains unknown, although her mother never became infected even though she was in contact with confirmed COVID-19 and asymptomatic patients.

Recent evidence demonstrates SARS-CoV-2 viral RNA is detectable in feces during recovery period of COVID-19 pneumonia [5, 6] . Intriguingly, studies have also illustrated that both adult and children patients of COVID-19 persistently tested positive on anal swabs even after nasopharyngeal testing was negative [7, 8] .

This case will further provide the new information that, besides confirmed COVID-19 patients, the asymptomatic SARS-CoV-2 infected case can be persistently tested positive in the stool samples but negative in nasopharyngeal swabs for a long time.

The number of asymptomatic infections is rapidly increasing all around the world [9] . Asymptomatic patients may be unaware of their SARS-CoV-2 infection status and therefore transmit the virus to others unknowingly if they are not isolated for medical observation. To control the quick and widespread

A novel coronavirus from patients with pneumoniain China

The presence of SARS-CoV-2 RNA in feces of COVID-19 patients

Fecal specimen diagnosis 2019 novel coronavirus-infected pneumonia

Fecal transmission in COVID-19: A potential shedding route

Detection of SARS-CoV-2 by RT-PCR in anal from patients who have recovered from coronavirus disease 2019

Detectable SARS-CoV-2 viral RNA in feces of three children during recovery period of COVID-19 pneumonia

Prolonged presence of SARS-CoV-2 viral RNA in faecal samples

Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding

Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2)

Figure 1 Chronology of symptom onset and identification of positive SARS-CoV-2 findings on quantitative RT-PCR

Prevention and Control Project of Bishan Science and Technology Bureau.