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Dynamics of urinary and respiratory shedding of Severe acute respiratory syndrome virus 2 (SARS-CoV-2) RNA excludes urine as a relevant source of viral transmission.
Mumm, Jan-Niclas; Ledderose, Stephan; Ostermann, Andreas; Rudelius, Martina; Hellmuth, Johannes C; Münchhoff, Max; Munker, Dieter; Scherer, Clemens; Volz, Yannic; Ebner, Benedikt; Giessen-Jung, Clemens; Lampert, Christopher; Vilsmaier, Theresa; Schneider, Stephanie; Gapp, Madeleine; Milger-Kneidinger, Katrin; Behr, Jürgen; von Bergwelt-Baildon, Michael; Keppler, Oliver T; Stief, Christian; Magistro, Giuseppe; Staehler, Michael; Rodler, Severin.
  • Mumm JN; Department of Urology, University Hospital, Ludwig Maximilian University of Munich (LMU), Marchioninistr. 15, 81377, Munich, Germany.
  • Ledderose S; Institute of Pathology, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany.
  • Ostermann A; Max Von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Ludwig Maximilian University, Munich, Germany.
  • Rudelius M; German Center for Infection Research, Partner Site Munich, Germany and Associated Partner Site Charité Berlin, Germany and Associated Partner Site Frankfurt, Munich, Germany.
  • Hellmuth JC; Institute of Pathology, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany.
  • Münchhoff M; Department of Medicine III and Comprehensive Cancer Center, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany.
  • Munker D; COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, LMU Munich, Munich, Germany.
  • Scherer C; Max Von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Ludwig Maximilian University, Munich, Germany.
  • Volz Y; German Center for Infection Research, Partner Site Munich, Germany and Associated Partner Site Charité Berlin, Germany and Associated Partner Site Frankfurt, Munich, Germany.
  • Ebner B; COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, LMU Munich, Munich, Germany.
  • Giessen-Jung C; Department of Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany.
  • Lampert C; COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, LMU Munich, Munich, Germany.
  • Vilsmaier T; Department of Medicine I, University Hospital, LMU Munich, Munich, Germany.
  • Schneider S; Department of Urology, University Hospital, Ludwig Maximilian University of Munich (LMU), Marchioninistr. 15, 81377, Munich, Germany.
  • Gapp M; Department of Urology, University Hospital, Ludwig Maximilian University of Munich (LMU), Marchioninistr. 15, 81377, Munich, Germany.
  • Milger-Kneidinger K; Department of Medicine III and Comprehensive Cancer Center, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany.
  • Behr J; Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Munich, Germany.
  • von Bergwelt-Baildon M; Department of Gynecology, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany.
  • Keppler OT; Max Von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Ludwig Maximilian University, Munich, Germany.
  • Stief C; Max Von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Ludwig Maximilian University, Munich, Germany.
  • Magistro G; Department of Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany.
  • Staehler M; Department of Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany.
  • Rodler S; German Center for Infection Research, Partner Site Munich, Germany and Associated Partner Site Charité Berlin, Germany and Associated Partner Site Frankfurt, Munich, Germany.
Infection ; 2021 Oct 30.
Article in English | MEDLINE | ID: covidwho-1491465
ABSTRACT

PURPOSE:

To investigate the expression of the receptor protein ACE-2 alongside the urinary tract, urinary shedding and urinary stability of SARS-CoV-2 RNA.

METHODS:

Immunohistochemical staining was performed on tissue from urological surgery of 10 patients. Further, patients treated for coronavirus disease (COVID-19) at specialized care-units of a university hospital were assessed for detection of SARS-CoV-2 RNA in urinary samples via PCR, disease severity (WHO score), inflammatory response of patients. Finally, the stability of SARS-CoV-2 RNA in urine was analyzed.

RESULTS:

High ACE-2 expression (3/3) was observed in the tubules of the kidney and prostate glands, moderate expression in urothelial cells of the bladder (0-2/3) and no expression in kidney glomeruli, muscularis of the bladder and stroma of the prostate (0/3). SARS-CoV-2 RNA was detected in 5/199 urine samples from 64 patients. Viral RNA was detected in the first urinary sample of sequential samples. Viral RNA load from other specimen as nasopharyngeal swabs (NPS) or endotracheal aspirates revealed higher levels than from urine. Detection of SARS-CoV-2 RNA in urine was not associated with impaired WHO score (median 5, range 3-8 vs median 4, range 1-8, p = 0.314), peak white blood cell count (median 24.1 × 1000/ml, range 5.19-48.1 versus median 11.9 × 1000/ml, range 2.9-60.3, p = 0.307), peak CRP (median 20.7 mg/dl, 4.2-40.2 versus median 11.9 mg/dl, range 0.1-51.9, p = 0.316) or peak IL-6 levels (median 1442 ng/ml, range 26.7-3918 versus median 140 ng/ml, range 3.0-11,041, p = 0.099). SARS-CoV-2 RNA was stable under different storage conditions and after freeze-thaw cycles.

CONCLUSIONS:

SARS-CoV-2 RNA in the urine of COVID-19 patients occurs infrequently. The viral RNA load and dynamics of SARS-CoV-2 RNA shedding suggest no relevant route of transmission through the urinary tract.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Language: English Year: 2021 Document Type: Article Affiliation country: S15010-021-01724-4

Full text: Available Collection: International databases Database: MEDLINE Language: English Year: 2021 Document Type: Article Affiliation country: S15010-021-01724-4