Legend: NS, nasal swab; RS, rectal swab;ND, no data;*median
were not available for one/two positive value.
The transmission of SARS-CoV-2 through direct contact with infected
secretion or aerosol droplets is well known.5 However,
in the past epidemics caused by other Coronavirus (SARS-CoV-1 and
MERS-CoV), viral RNA was also detected in several clinical specimens
such as 42% urine, 97% stool and 50% plasma.6-8 In
this respect, these materials have been considered as useful clinical
samples to improve laboratory diagnosis.
Also, the possibility of different SARS-CoV-2 transmission routes could
be contemplated. In this brief report, we described the presence of the
virus in different clinical samples, including RS, plasma, and urine,
supporting the evidence of a potential shed of the virus through
fecal-oral or body fluid routes.
In this study, the highest rate of positive RT-PCR for SARS-CoV-2 was
detected in RS specimens (10.3%), suggesting that SARS-CoV-2 may be
transmitted by the fecal route.5 However, this rate is
lower than SARS-CoV-1.
Focusing on plasma samples, we reported only a few cases of positive RNA
detection in plasma (7.7%), but higher than that reported by Wang et
al.,5 suggesting a systemic infection can occur
although less frequently with respect to 50%
SARS-CoV-1.9
The SARS-CoV-2 was rarely detected in urine, and, to date, no other
authors reported a significant presence of the virus in urine of
COVID-19 patients.
Although SARS-CoV-2 was detected in specimens from multiple sites of
patients with positive NS for COVID-19, no positive results were
obtained in patients with negative NS, supporting the hypothesis that
respiratory samples represent the gold standard for COVID-19 molecular
diagnosis.
Transmission of SARS-CoV-2 by respiratory droplets and other way routes
highlights the risk of contagious via environmental contamination with
infected clinical specimens, highlighting the importance of protection
and decontamination procedures despite extensive contamination of
inanimate surfaces.10 Longitudinal studies should be
performed to evaluate the incidence of SARS-CoV-2 RNA in specimens
different from respiratory samples.