ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Direct Evidence of Active SARS-CoV-2 Replication in the Intestine.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 106 papers, 1 of them a synthesis that pooled it.
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Who cites it
106 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Oro-faecal transmission of SARS-CoV-2: A systematic review of studies employing viral culture from gastrointestinal and other potential oro-faecal sources and evidence for transmission to humans.Epidemiology and infection · 2024Pooled it
- Efficacy of Niclosamide vs Placebo in SARS-CoV-2 Respiratory Viral Clearance, Viral Shedding, and Duration of Symptoms Among Patients With Mild to Moderate COVID-19: A Phase 2 Randomized Clinical Trial.JAMA network open · 2022Trial
- Probiotics and Bacteriocins Against SARS-CoV-2: Therapeutic Frontiers and Mechanistic Insights.Probiotics and antimicrobial proteins · 2026Review
- SARS-CoV-2 Persistence and the Gut Microbiota: New Insights into Long COVID Pathogenesis.Viruses · 2026Review
- A survey of SARS-CoV-2 tropism.Infectious diseases & immunity · 2025Review
- Long-Term Impact of COVID-19 on Disorders of Gut-Brain Interaction: Incidence, Symptom Burden, and Psychological Comorbidities.United European gastroenterology journal · 2025Article
- Characterization of the gut microbiota in drug abuse: prediction, prevention, and personalized medicine to benefit affected populations.The EPMA journal · 2025Review
- Compromised efferocytosis during aging is related to COVID-19 severity in mice.Virologica Sinica · 2025Article
- Relationship Between Acute SARS-CoV-2 Viral Clearance and Long COVID-19 (Long COVID) Symptoms: A Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Human microbiome in post-acute COVID-19 syndrome (PACS).Current research in microbial sciences · 2025Article
- Investigating the Interplay of SARS-CoV-2 RNAemia and Peripheral Inflammation in Platelet Dysfunction During Acute SARS-CoV-2 Infection.Pathogens & immunity · 2025Article
- SARS-CoV-2 infection perturbs the gastrointestinal tract and induces modest microbial translocation across the intestinal barrier.Journal of virology · 2024Article
- Long COVID and gut candidiasis: What is the existing relationship?World journal of gastroenterology · 2024Review
- Review
- Relationship between acute SARS-CoV-2 viral clearance with Long COVID Symptoms: a cohort study.medRxiv : the preprint server for health sciences · 2024Article
- Review
- Excretion of SARS-CoV-2 RNA in feces has no prognostic benefit in the outcome of COVID-19: A clinical and immunological study.Biomolecules & biomedicine · 2024Article
- Prevalence and duration of SARS-CoV-2 fecal shedding in breastfeeding dyads following maternal COVID-19 diagnosis.Frontiers in immunology · 2024Article
- SARS-CoV-2 envelope protein induces necroptosis and mediates inflammatory response in lung and colon cells through receptor interacting protein kinase 1.Apoptosis : an international journal on programmed cell death · 2023Article
- SARS-CoV-2 and the DNA damage response.The Journal of general virology · 2023Review
46 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrently, there is no direct evidence to prove the active replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the intestinal tract and relevant pathological changes in the colon and rectum. We investigated the presence of virions and pathological changes in surgical rectal tissues of a patient with clinically confirmed coronavirus disease 2019 (COVID-19) with rectal adenocarcinoma.
methodsThe clinical data were collected during hospitalization and follow-up of this patient. Quantitative reverse transcriptase-polymerasechain reaction (RT-PCR) was performed on the rectal tissue specimens obtained from surgical resection, succus entericus and intestinal mucosa of ileostomy, and rectal mucosa during follow-up after recovery. Ultrathin sections of surgical samples were observed for SARS-CoV-2 virions using electron microscopy. Histopathological examination was performed using hematoxylin-eosin stain. Immunohistochemical analysis and immunofluorescence were carried out on rectal tissues to evaluate the distribution of SARS-CoV-2 antigen and immune cell infiltrations.
resultsThe patient had fever and cough on day 3 postoperatively, was diagnosed with COVID-19 on day 7, and was discharged from the hospital on day 41. RNA of SARS-CoV-2 was detected in surgically resected rectal specimens but not in samples collected 37 days after discharge. Notably, coincident with rectal tissues of surgical specimens testing nucleic acid positive for SARS-CoV-2, typical coronavirus virions in rectal tissue were observed under electron microscopy. Moreover, abundant lymphocytes and macrophages (some were SARS-CoV-2 positive) infiltrating the lamina propria were found with no significant mucosal damage.
conclusionsWe first report the direct evidence of active SARS-CoV-2 replication in a patient's rectum during the incubation period, which might explain SARS-CoV-2 fecal-oral transmission.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.