key: cord-0780727-awcrz0s4
authors: Culver, Aurélien; Arbelot, Charlotte; Bechis, Carole; Cassir, Nadim; Leone, Marc
title: First description of SARS-CoV-2 in ascites
date: 2020-05-21
journal: IDCases
DOI: 10.1016/j.idcr.2020.e00836
sha: 22becc4c48df646d3449dcbaedd1aa177e07556b
doc_id: 780727
cord_uid: awcrz0s4

nan

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To our knowledge, this is the first description of SARS-CoV-2 RNA detection from the ascitic fluid of a Covid-19 patient. While coronavirus RNA detection from peritoneal fluid has already been shown in animal models (2) , no data are available on the presence of enveloped viruses in human ascites.

Regarding SARS-CoV-2, infectious virus has been readily isolated from nasopharyngal-and lungderived samples but not from stool samples -in spite of high virus RNA concentration -or from blood samples (3) . However, until further knowledge on virus viability in ascites fluid can be attained, we suggest that healthcare workers with exposure to ascitic fluid from Covid-19 patients should utilize high-level personal protective equipment.

In this patient, both blood and ascites samples were positive for SARS-CoV-2 RNA. Notably, no blood cells were observed in the transudative ascites, implying an active viral replication in ascites fluid. The

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ACE2 receptor is highly expressed in esophageal epithelial cells and the absorptive enterocytes from the ileum and colon, suggesting a possible pathway to ascites infection (4) . Whether cirrhosis decompensation is related to the already described SARS-CoV-2 liver damage (5) or ascites infection remains an unresolved issue that needs further research.We declare no competing interests.We would like to thank all the nursing and medical staff taking care of Covid patients in our hospital.