ABSTRACT
The Coronaviridae family's severe acute respiratory syndrome corona virus 2 (SARS-Co V-2) outbreak has infected a large number of the population during the COVID- 19 pandemic. The most prominent mode of virus transmission is considered through respiratory droplets of the infected person. Virus-mediated respiratory infection depends upon the binding between spike protein and the Angiotensinconverting enzyme 2 (ACE2) receptor expressed in lung alveolar type 2 cells. But some studies reported that gastrointestinal infection is also one of the prominent symptoms of COVID-19 because of the high expression of the ACE2 receptor in absorptive enterocytes of the small intestine. In a country like India, with high population density and due to unhygienic sanitation, it is crucial to understand the potential fecal-oral transmission route of SARS-CoV-2 during infection because of presence of ACE2 in small intestine. Therefore in our study, we aim to trace the potential fecal-oral transmission route of SARS-Co V-2 by examining human stool (collected from hospital settings) and nearby sewage water systems, followed by molecular characterization and viral load kinetics evaluation of SARSCOV- 2. qRT-PCR and NGS sequencing methods were used. The presence of SARS-COV-2 was reported in around 70% of samples (both clinical and environmental), this will help us to establish the epidemiological link between clinical and environmental samples after genomic analysis to alter the circulation of silent SARS Co V2 in the community.