While doctors have focused on respiratory samples from pneumonia cases to identify coronavirus patients, they might have ignored a less apparent and hidden source of the spread: diarrhea.
The novel coronavirus was detected in the loose stool of the first US case — a finding that hasn’t featured among case reports from Wuhan, China, the epicenter of the outbreak. However, that doesn’t surprise scientists who have studied coronaviruses, nor doctors familiar with the bug that caused SARS.
Diarrhea occurred in about 10-20% of patients afflicted with severe acute respiratory syndrome about 17 years ago and was the source of an explosive SARS outbreak in the Amoy Gardens residential complex in Hong Kong.
SARS and Wuhan viruses bind to the same distinctly shaped protein receptors in the body that are expressed in the lungs and intestines, making these organs the primary targets for both viruses, said Fang Li, an associate professor of veterinary and biomedical sciences at the University of Minnesota.
“The initial focus of case detection was on patients with pneumonia, but we now understand that some patients can present with gastrointestinal symptoms,” Feng and co-authors said in their report, which was published in the New England Journal of Medicine.