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10.1016/S2666-5247(21)00059-8

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33821247!8012028!33821247
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suck abstract from ncbi


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pmid33821247      Lancet+Microbe 2021 ; 2 (6): e259-e266
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  • A method for detection of SARS-CoV-2 RNA in healthy human stool: a validation study #MMPMID33821247
  • Coryell MP; Iakiviak M; Pereira N; Murugkar PP; Rippe J; Williams DB; Heald-Sargent T; Sanchez-Pinto LN; Chavez J; Hastie JL; Sava RL; Lien CZ; Wang TT; Muller WJ; Fischbach MA; Carlson PE Jr
  • Lancet Microbe 2021[Jun]; 2 (6): e259-e266 PMID33821247show ga
  • BACKGROUND: Faecal shedding of SARS-CoV-2 has raised concerns about transmission through faecal microbiota transplantation procedures. Validation parameters of authorised tests for SARS-CoV-2 RNA detection in respiratory samples are described in product labelling, whereas the published methods for SARS-CoV-2 detection from faecal samples have not permitted a robust description of the assay parameters. We aimed to develop and validate a test specifically for detection of SARS-CoV-2 in human stool. METHODS: In this validation study, we evaluated performance characteristics of a reverse transcriptase real-time PCR (RT-rtPCR) test for detection of SARS-CoV-2 in human stool specimens by spiking stool with inactivated SARS-CoV-2 material. A modified version of the US Centers for Disease Control and Prevention RT-rtPCR SARS-CoV-2 test was used for detection of viral RNA. Analytical sensitivity was evaluated in freshly spiked stool by testing two-fold dilutions in replicates of 20. Masked samples were tested by a second laboratory to evaluate interlaboratory reproducibility. Short-term (7-day) stability of viral RNA in stool samples was assessed with four different stool storage buffers (phosphate-buffered saline, Cary-Blair medium, Stool Transport and Recovery [STAR] buffer, and DNA/RNA Shield) kept at -80 degrees C, 4 degrees C, and ambient temperature (approximately 21 degrees C). We also tested clinical stool and anal swab specimens from patients who were SARS-CoV-2 positive by nasopharyngeal testing. FINDINGS: The lower limit of detection of the assay was found to be 3000 viral RNA copies per g of original stool sample, with 100% detection across 20 replicates assessed at this concentration. Analytical sensitivity was diminished by approximately two times after a single freeze-thaw cycle at -80 degrees C. At 100 times the limit of detection, spiked samples were generally stable in all four stool storage buffers tested for up to 7 days, with maximum changes in mean threshold cycle values observed at -80 degrees C storage in Cary-Blair medium (from 29.4 [SD 0.27] at baseline to 30.8 [0.17] at day 7; p<0.0001), at 4 degrees C storage in DNA/RNA Shield (from 28.5 [0.15] to 29.8 [0.09]; p=0.0019), and at ambient temperature in STAR buffer (from 30.4 [0.24] to 32.4 [0.62]; p=0.0083). 30 contrived SARS-CoV-2 samples were tested by a second laboratory and were correctly identified as positive or negative in at least one of two rounds of testing. Additionally, SARS-CoV-2 RNA was detected using this assay in the stool and anal swab specimens of 11 of 23 individuals known to be positive for SARS-CoV-2. INTERPRETATION: This is a sensitive and reproducible assay for detection of SARS-CoV-2 RNA in human stool, with potential uses in faecal microbiota transplantation donor screening, sewage monitoring, and further research into the effects of faecal shedding on the epidemiology of the COVID-19 pandemic. FUNDING: National Institute of Allergy and Infectious Diseases, US National Institutes of Health; Center for Biologics Evaluation and Research, US Food and Drug Administration.
  • |*COVID-19/diagnosis[MESH]
  • |*SARS-CoV-2/genetics[MESH]
  • |Humans[MESH]
  • |Pandemics[MESH]
  • |RNA, Viral/genetics[MESH]


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