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J Korean Med Sci ; 36(44): e301, 2021 Nov 15.
Article in English | MEDLINE | ID: covidwho-1526760


We used serial rectal swabs to investigate the amount and duration of virus secretion through the gastrointestinal tract and assessed the association between fecal shedding and gastrointestinal symptoms and to clarify the clinical usefulness testing rectal swabs. We enrolled ten adult patients hospitalized with symptomatic coronavirus disease 2019 (COVID-19). Respiratory and stool specimens were collected by physicians. The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed using real-time reverse-transcription polymerase chain reaction. All ten patients had respiratory symptoms, six had diarrhea, and seven were positive for SARS-CoV-2 on rectal swabs. The viral loads in the respiratory specimens was higher than those in the rectal specimens, and no rectal specimens were positive after the respiratory specimens became negative. There was no association between gastrointestinal symptoms, pneumonia, severity, and rectal viral load. Rectal swabs may play a role in detecting SARS-CoV-2 in individuals with suspected COVID-19, regardless of gastrointestinal symptoms.

COVID-19 Nucleic Acid Testing/methods , COVID-19/virology , Rectum/virology , SARS-CoV-2/isolation & purification , Virus Shedding , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/complications , COVID-19/transmission , Diarrhea/etiology , Diarrhea/virology , Feces/virology , Female , Humans , Male , Middle Aged , Nasopharynx/virology , Prospective Studies , Real-Time Polymerase Chain Reaction , Severity of Illness Index , Time Factors , Viral Load
PLoS One ; 15(8): e0237692, 2020.
Article in English | MEDLINE | ID: covidwho-717607


BACKGROUND: Our hospital experienced the first healthcare-associated COVID-19 outbreak in Seoul at the time the first COVID-19 cases were confirmed in Korea. The first confirmed COVID-19 patient was a hospital personnel who was in charge of transferring patients inside our hospital. To contain the virus spread, we shutdown our hospital, and tested all inpatients, medical staff members, and employees. METHODS: We retrospectively analyzed the results of SARS-CoV-2 RT-PCR testing according to the contact history, occupation, and presence of respiratory symptoms. Closed-circuit television (CCTV) was reviewed in the presence of an epidemiologist to identify individuals who came into contact with confirmed COVID-19 patients. RESULTS: A total of 3,091 respiratory samples from 2,924 individuals were obtained. Among 2,924 individuals, two inpatients, and one caregiver tested positive (positivity rate, 0.1%). Although all confirmed cases were linked to a general ward designated for pulmonology patients, no medical staff members, medical support personnel, or employees working at the same ward were infected. Contact with confirmed COVID-19 cases was frequent among inpatients and medical support personnel. The most common contact area was the general ward for pulmonology patients and medical support areas, including clinical and imaging examination rooms. Finally, the total number of hospital-associated infections was 14, consisting of four diagnosed at our hospital and ten diagnosed outside the hospital. CONCLUSIONS: The robust control of the COVID-19 outbreak further minimized the transmission of SARS-CoV-2 in the hospital and local communities. However, there was also a debate over the appropriate period of hospital shutdown and testing of all hospital staff and patients. Future studies are required to refine and establish the in-hospital quarantine and de-isolation guidelines based on the epidemiological and clinical settings.

Betacoronavirus/genetics , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Cross Infection/epidemiology , Cross Infection/prevention & control , Disease Transmission, Infectious/prevention & control , Hospitals, University , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Adult , Aged , Aged, 80 and over , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Cross Infection/virology , Female , Health Personnel , Humans , Male , Middle Aged , Patients' Rooms , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , Quarantine/methods , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2 , Seoul/epidemiology , Young Adult
Korean J Helicobacter Up Gastrointest Res ; 20(2):86-90, 2020.
Article | WHO COVID | ID: covidwho-678689


Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has become a global pandemic and is now the most threatening public health issue. Patients with the infection present with high fever and pneumonia with respiratory symptoms, but some patients also develop digestive symptoms such as diarrhea, vomiting, and abdominal pain. This may be the basis for the transmission route of the new virus, not only for respiratory infection through droplets but also for fecal-to-oral transmission. In addition, the high expression level of angiotensin-converting enzyme 2 on the surface cells in the gastrointestinal tract may support the occurrence of digestive symptoms and the possibility of fecal-to-oral transmission. Recent studies have shown positive fecal polymerase chain reaction (PCR) test results in patients with the infection who showed digestive symptoms. Therefore, we reviewed the related literature on the occurrence of digestive symptoms in patients with COVID-19 and present the usefulness and clinical application of the fecal PCR test for identifying the potential infection route and criteria for isolation.