norovirus, adenovirus), the likelihood of SARS-CoV-2 being transmitted via feces or urine appears much lower due to the lower relative amounts of virus present in feces/urine. In comparison to enteric viruses transmitted via the fecal-oral route (e.g. The level and infectious capability of SARS-CoV-2 in vomit remain unknown. There is strong evidence of multiplication of SARS-CoV-2 in the gut and infectious virus has occasionally been recovered from both urine and stool samples.
10 2-10 7 gc/ml) is much lower than in nasopharyngeal fluids (ca. The abundance of the virus genetic material in both urine (ca. SARS-CoV-2 RNA is occasionally detected in urine, but reports in fecal samples are more frequent. Fecal shedding of the virus peaks in the symptomatic period and can persist for several weeks, but with declining abundances in the post-symptomatic phase. In addition to these cases, SARS-CoV-2 RNA can be detected in feces from some asymptomatic, mildly- and pre-symptomatic individuals. A review of 48 independent studies revealed that severe GI dysfunction is only evident in a small number of COVID-19 cases, with 11 ± 2% exhibiting diarrhea and 12 ± 3% exhibiting vomiting and nausea. This review aims to critically evaluate the incidence of gastrointestinal (GI) symptoms, the quantity and infectivity of SARS-CoV-2 in feces and urine, and whether these pose an infection risk in sanitary settings, sewage networks, wastewater treatment plants, and the wider environment (e.g. The recent detection of SARS-CoV-2 RNA in feces has led to speculation that it can be transmitted via the fecal-oral/ocular route. 10 Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5AB, UK.9 Healthcare Associated Infections Research Group, Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, UK.8 Leeds Institute for Medical Research, Faculty of Medicine and Health, University of Leeds, Leeds LS1 3EX, UK.
7 European Centre for Environment and Human Health, University of Exeter Medical School, ESI, Penryn Campus, TR10 9FE, UK.6 Organisms and Environment Division, School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK Public Health Wales, University Hospital of Wales, Cardiff CF14 4XW, UK.5 School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5AB, UK.4 Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK.3 The Roslin Institute and Royal (Dick) School of Veterinary Studies, Easter Bush Campus Midlothian, EH25 9RG, UK.Electronic address: 2 School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK. 1 Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK UWA School of Agriculture and Environment, The University of Western Australia, Perth, WA 6009, Australia.
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