Detection and Isolation of SARS-CoV-2 in Serum, Urine, and Stool Specimens of COVID-19 Patients from the Republic of Korea

Objectives Coronavirus Disease-19 (COVID-19) is a respiratory infection characterized by the main symptoms of pneumonia and fever. It is caused by the novel coronavirus severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), which is known to spread via respiratory droplets. We aimed to determ...

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Main Authors: Jeong-Min Kim, Heui Man Kim, Eun Jung Lee, Hye Jun Jo, Youngsil Yoon, Nam-Joo Lee, Junseock Son, Ye-Ji Lee, Mi Seon Kim, Yong-Pyo Lee, Su-Jin Chae, Kye Ryeong Park, Seung-Rye Cho, Sehee Park, Su Jin Kim, Eunbyeol Wang, SangHee Woo, Aram Lim, Su-Jin Park, JunHyeong Jang, Yoon-Seok Chung, Bum Sik Chin, Jin-Soo Lee, Duko Lim, Myung-Guk Han, Cheon Kwon Yoo
Format: Article
Language:English
Published: Korea Disease Control and Prevention Agency 2020-05-01
Series:Osong Public Health and Research Perspectives
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Online Access:http://ophrp.org/upload/pdf/j-phrp-2020-11-3-02.pdf
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Summary:Objectives Coronavirus Disease-19 (COVID-19) is a respiratory infection characterized by the main symptoms of pneumonia and fever. It is caused by the novel coronavirus severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), which is known to spread via respiratory droplets. We aimed to determine the rate and likelihood of SARS-CoV-2 transmission from COVID-19 patients through non-respiratory routes. Methods Serum, urine, and stool samples were collected from 74 hospitalized patients diagnosed with COVID-19 based on the detection of SARS-CoV-2 in respiratory samples. The SARS-CoV-2 RNA genome was extracted from each specimen and real-time reverse transcription polymerase chain reaction performed. CaCo-2 cells were inoculated with the specimens containing the SARS-COV-2 genome, and subcultured for virus isolation. After culturing, viral replication in the cell supernatant was assessed. Results Of the samples collected from 74 COVID-19 patients, SARS-CoV-2 was detected in 15 serum, urine, or stool samples. The virus detection rate in the serum, urine, and stool samples were 2.8% (9/323), 0.8% (2/247), and 10.1% (13/129), and the mean viral load was 1,210 ± 1,861, 79 ± 30, and 3,176 ± 7,208 copy/µL, respectively. However, the SARS-CoV-2 was not isolated by the culture method from the samples that tested positive for the SARS-CoV-2 gene. Conclusion While the virus remained detectable in the respiratory samples of COVID-19 patients for several days after hospitalization, its detection in the serum, urine, and stool samples was intermittent. Since the virus could not be isolated from the SARS-COV-2-positive samples, the risk of viral transmission via stool and urine is expected to be low.
ISSN:2210-9099
2210-9110