Evidence for gastrointestinal infection of SARS-CoV-2 (Journal Pre-proof)

22 Mar, 2020
Since 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.