Gastroenteritis: Symptoms and Epidemiology of SARS-CoV-2

Previous studies on the coronavirus (CoVID-19) have shown that respiratory symptoms such as fever, dry cough, and shortness of breath are mainly the common manifestations at the onset of the infection. These symptoms are largely similar to severe acute respiratory syndrome (SARS), which prevailed in 2003, and the Middle East respiratory syndrome (MERS) in 2012, indicating droplet and contact transmission to be the reason for transmission. However, it is widely accepted that a range of common attributes, like diarrhea, nausea, vomiting, and abdominal discomfort, can be observed among various affected populations, along with an early and mild onset commonly followed by typical respiratory symptoms. Increasing affirmation from several recent research works on SARS-CoV-2 has indicated that the gastrointestinal tract (intestine) epithelium is a favorable host to SARS-CoV-2 coronavirus particles. These findings are confirmed by the viral detection in biopsy specimens and stool samples of even the positive patients, thus explaining at least partially the gastrointestinal symptoms in the patients. Additionally, the wastewater-based epidemiology studies being done by various countries suggest that individuals can start shedding the virus particles in the feces long before any of the key symptoms could be manifested or before the patients could be clinically diagnosed. These findings have ignited the questions on potential recurrence and transmission of COVID-19 from persistent fecal shedding from the infected individuals.

Keywords: COVID-19, Faecal-oral Transmission, Gastroenteritis, WBE.