COVID-19粪便传播可能性的研究

Research Progress on the Possibility of Faecal-Oral Transmission of COVID-19

2019年12月由新型冠状病毒(SARS-CoV-2)感染引发的新型冠状病毒肺炎(COVID-19)爆发,并在短时间内迅速蔓延至全世界,对全球公共卫生造成了严重威胁。SARS-CoV-2主要通过飞沫和近距离接触进行传播,具有较高的感染率。病毒进入人体后,主要在肺泡中复制,引起肺中炎症反应加剧,损害肺组织,严重患者出现急性呼吸窘迫综合征,部分患者出现多器官功能衰竭的重症肺炎,但有关报道发现部分患者伴随着胃肠道症状,在其粪便中也能检测到SARS-CoV-2的RNA,也可从粪便中分离到活病毒,这预示着粪便传播也是一种潜在的传播途径。通过检索2019年12月到2020年4月发表的国内外相关研究的文献,结合中东呼吸综合征(MERS)和重症急性呼吸综合征(SARS)的粪便传播的报道,对COVID-19粪便传播的可能性进行阐述,并提出预防粪便传播造成的传染性病例和环境污染的方法和措施。

Coronavirus disease 2019(COVID-19),which was caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),broke out in December 2019.It spread rapidly throughout the world in a short time and caused a serious threat to global public health.SARS-CoV-2 presents a high infection rate,which is mainly transmitted through droplet and close contact.After the virus enters the human body,it is mainly replicated in the alveoli,which aggravates the inflammatory reaction in the lung and damages the lung tissue.It is found that SARS-CoV-2 can cause acute respiratory distress syndrome(ARDS)and severe pneumonia with multiple organ failure(MOF)in some severe patients.It has been reported that the RNA of SARS-CoV-2,even the live virus can be detected in the stool of some COVID-19 patients with gastrointestinal symptoms,which indicates that faecal-oral transmission is also a potential route of transmission.By searching the literature published in China and abroad from December 2019 to April 2020,we discussed the possibility of faecal-oral transmission of COVID-19 and put forward the methods to prevent infectious cases and environmental pollution caused by faecal-oral transmission,combined with reports about the faecal-oral transmission of Middle East Respiratory Syndrome(MERS)and Severe Acute Respiratory Syndrome(SARS).