key: cord-1025356-1fyag5x3
authors: Zhang, Ning; Gong, Yuhuan; Meng, Fanping; Bi, Yuhai; Yang, Penghui; Wang, Fusheng
title: Virus shedding patterns in nasopharyngeal and fecal specimens of COVID-19 patients
date: 2020-03-30
journal: nan
DOI: 10.1101/2020.03.28.20043059
sha: e1b335bb18bd24115f4c25a5e83d18c15cdeb09c
doc_id: 1025356
cord_uid: 1fyag5x3

Diagnosis is the key point for confirmation and treatment of COVID-19. we focused on comparative analysis of virus dynamics between the upper respiratory and feces specimens in the COVID-19 patients. A total of 66 upper respiratory swabs, 51 feces, 56 urine and 56 plasma samples were sequentially collected from 23 patients in a designated hospital. The plasma and urine samples were all negative, except for urine samples from two severe cases at the latest available detection point. Conversely, virus was shed in respiratory swabs and feces samples during the diseased period. Ten of 12 (83.3%) cases were positive for feces samples, while 14 of 21 (66.7%) were positive for respiratory samples. In addition, the median duration of virus shedding was 10.0 days (IQR 8.0 to 17.0) in the upper respiratory swabs, but was 22.0 days (IQR 15.5 to 23.5) for the feces. Notably, at 26 days after discharge, case 3 (a 45-year-old) was detected positive again in the feces samples, but appears to be healthy and negative for respiratory swabs. These results indicated that beside respiratory samples, intestinal samples (e.g. feces) should be recommended for diagnosis of COVID-19, especially before a patient discharge and for monitoring the relapse of discharged patients.

perpetuity. preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in The copyright holder for this this version posted March 30, 2020. . https://doi.org/10.1101/2020.03.28.20043059 doi: medRxiv preprint 3 except for one due to an unrelated bacterial infection) ( Table S1 in fecal samples, and the highest virus titers at the peak was significantly higher for 62 feces (10 5.8 copies/ml, mean 5623 copies/ml) than of respiratory samples (10 6.3 63 copies/ml, mean 2535 copies/ml) ( Figure 1A) . Notably, at 26 days after discharge, 64 case 3 was detected positive again in feces samples, but appears to be healthy and 65 negative for respiratory swabs. These results indicated that beside respiratory samples, 66 All rights reserved. No reuse allowed without permission. perpetuity. preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in 

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All rights reserved. No reuse allowed without permission. perpetuity. preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in The copyright holder for this this version posted March 30, 2020. perpetuity. preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in The copyright holder for this this version posted March 30, 2020. . https://doi.org/10.1101/2020.03.28.20043059 doi: medRxiv preprint