Evidence for gastrointestinal infection of SARS-CoV-2 (Journal Pre-proof)
22 Mar, 2020Since the novel coronavirus (SARS-CoV-2) was identified in Wuhan, China, at the
end of 2019, the virus has spread to 32 countries, infecting more than 80000 people
and causing over 2600 deaths globally. The viral infection causes a series of
respiratory illness including severe respiratory syndrome, indicating the virus most
likely infects respiratory epithelial cells and spreads mainly via respiratory tract from
human to human. However, viral target cells and organs haven’t been fully
determined, impeding our understanding of the pathogenesis of the viral infection and
viral transmission routes. According to a recent case report, SARS-CoV-2 RNA was
detected in a stool specimen[1], raising the question of viral gastrointestinal infection
and fecal-oral transmission route. It has been proved that SARS-CoV-2 uses ACE2 as
a viral receptor for entry process[2] . ACE2 mRNA is highly expressed and stabilized
by B0AT1 in gastrointestinal system[3, 4], providing a prerequisite for SARS-CoV-2
infection. To further investigate the clinical significance of SARS-CoV-2 RNA in
feces, we examined the viral RNA in feces from 71 patients with SARS-CoV-2
infection during their hospitalization. The viral RNA and viral nucleocapsid protein
were examined in gastrointestinal tissues from one of the patients.