Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, formerly 2019-nCoV, Wuhan coronavirus) is present in the fecal matter of approximately half of the patients.
This could be an important method of transmission.
A tweet related to the paper advised closing the toilet lid after flushing because aerosols from the spray during flushing can travel up to 20 feet.
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https://www.medrxiv.org/content/10.1101/2020.02.17.20023721v1
Evidence for gastrointestinal infection of SARS-CoV-2
Abstract (lines 62 to 74):
The new coronavirus (SARS-CoV-2) outbreak originating from Wuhan, China, poses a threat to global health. While it's evident that the virus invades respiratory tract and transmits from human to human through airway, other viral tropisms and transmission routes remain unknown. We tested viral RNA in stool from 73 SARS-CoV-2-infected hospitalized patients using rRT-PCR. 53.42% of the patients tested positive in stool. 23.29% of the patients remained positive in feces even after the viral RNA decreased to undetectable level in respiratory tract. The viral RNA was also detected in gastrointestinal tissues. Furthermore, gastric, duodenal and rectal epithelia showed positive immunofluorescent staining of viral host receptor ACE2 and viral nucleocapsid protein in a case of SARS-CoV-2 infection. Our results provide evidence for gastrointestinal infection of SARS-CoV-2, highlighting its potential fecal-oral transmission route.
From the paper's intro (lines 91 to 98):
According to a recent case report, SARS-CoV-2 RNA was detected in a stool specimen, indicating the possibility of the viral extrarespiratory infection and additional transmission routes to respiratory one. It has been proved that SARS-CoV-2 uses ACE2 as a viral receptor for entry process. ACE2 mRNA is highly expressed in gastrointestinal system, providing a prerequisite for SARS-CoV-2 infection. To further understand the clinical significance of SARS-CoV-2 RNA in feces, we examined the viral RNA in feces from 71 patients with SARS-CoV-2 during their hospitalization.
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PDF of full preprint paper at:
https://www.medrxiv.org/content/10.1101/2020.02.17.20023721v1.full.pdf
https://doi.org/10.1101/2020.02.17.20023721