Researchers say they have discovered that in some patients where COVID-19 might have cleared in the respiratory tract, the virus continues to replicate in the gastrointestinal tract and could be shed in faeces.
However, the scientists say there are currently no data showing how long the contagion remains viable in faeces.
The respiratory tract consists of the nose, pharynx, larynx, trachea, and the lung with its different compartments; while the gastrointestinal tract comprises the mouth, oesophagus, stomach, small intestine, large intestine, and anus.
The liver, pancreas, and gallbladder make up the solid organs of the digestive system..
Study authors, Prof. Lijing Yang and Dr. Lei Tu, say although respiratory tract manifestations are the most commonly reported symptoms of COVID-19, emerging data suggests that the gastrointestinal tract and liver might also be affected by the virus.
They said this is because gastrointestinal epithelial cells and liver cells express angiotensin-converting enzyme 2 — the major receptor of SARS-CoV-2.
The researchers had cultured four SARS-CoV-2 positive faecal specimens with high copy numbers and detected live virus using electron microscopy detection.
The findings imply that in some patients, although SARS-CoV-2 has been cleared in the respiratory tract, the virus continues to replicate in the gastrointestinal tract and could be shed in faeces.
The study was titled, ‘Implications of gastrointestinal manifestations of COVID-19,’ and published in peer-reviewed The Lancet journal.
Reacting to the study, a Senior Registrar, Gastroenterology and Haematology Unit at the Lagos University Teaching Hospital, Dr. Cara Cookey, says the gastrointestinal tract is a big organ with many hidden hollow sites that can prevent bacterial infections such as typhoid; or a viral infection like COVID-19, from being detected.
Cookey said it was a known fact that the gastrointestinal tract has several nests that hide viruses and bacteria.
“It does happen, because the gastrointestinal tract also has a receptor that can be penetrated by COVID-19.
“The gastrointestinal tract is a big organ with lots of hidden sites that the virus can hide in. Therefore, clearing the infection may not be fast.
“It is not different from typhoid case. There are some people who are regarded as typhoid sharer. If you test them, they don’t have it. But go to their gallbladder, you will see the bacteria there,” she said.
She said people who repeatedly have typhoid fever flout simple hygiene rules. “They are the type who will use the toilet, avoid washing hands and then use those same hands to cook food thereby infecting many people,” she stated.
The registrar cited the case of Mary Mallon, also known as ‘Typhoid Mary,’ as a reference.
According to her, Typhoid Mary was an Irish-born cook believed to have been born with typhoid because her mother was infected during pregnancy in the 19th Century.
She reportedly infected 53 people with typhoid fever, three of whom died; and she became the first person identified as an asymptomatic carrier of the infectious disease in the United States.
“Because she persisted in working as a cook, by which she exposed others to the disease, she was twice forcibly quarantined by authorities, and died after a total of nearly three decades in isolation.
“The simple solution to avoid gastrointestinal tract infection is to maintain hygiene and ensure you don’t spread the disease to others. The end product of the gastrointestinal tract is, of course, the production of faeces,” she said.
She also stressed that it was not only respiratory organs that fail during COVID-19 complication.
“What causes death is multiple organs failure, we are not just talking about only respiratory tract. The gastrointestinal tract and other vital organs also fail.
“However, many people are known to have recovered from it, depending on their immunity. That is not ruling out the fact that there may be a report of the general weakness of the body, nausea and diarrhoea.
“COVID-19 is a novel virus which throws up new revelations and discoveries every day.
“There are some people whose oxygen-saturation is low, yet they look normal to the public.
“There is a dissociation between the oxygen level and the appearance of the person in question.
“Most people survive it, except those with underlying conditions who are already immune-compromised,” she noted.
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