OBJECTIVES: Assessment of whether SARS-CoV-2 has been propagated during intestinal passage and infectivity is conserved when shed rectally by hospitalised patients. METHODS: An exploratory cohort study including 28 COVID-19 inpatients with estimation of RNA levels by RT-PCR and viral infectivity by culturing of viral material sampled concomitantly and identically from pharynx and rectum. RESULTS: SARS-CoV-2 RNA was detected more frequently (91%, 30/33 vs. 42%, 14/33, p<0.0001) and at higher concentrations (median levels 2,190,186 IU/mL vs. 13,014 IU/mL, p<0.0001) in the pharyngeal swabs than in the rectal swabs. For all sample pairs (n=33) the rectal swabs contained undetectable or lower SARS-CoV-2 RNA concentrations than their paired pharyngeal swabs. Replicative virus was found in 37% (11/30) of the PCR-positive pharyngeal swabs, whereas none of the PCR-positive rectal swabs could be cultured (0%, 0/14) despite containing SARS-CoV-2 RNA concentrations up to 1,544,691 IU/mL. CONCLUSIONS: Our data draw into question whether SARS-CoV-2 is transmitted readily from faeces.
Rectally shed SARS-CoV-2 in COVID-19 inpatients is consistently lower than respiratory shedding and lacks infectivity