Can COVID-19 spread through fecal matter?

"Potential Fecal Transmission of SARS-CoV-2: Current Evidence and Implications for Public Health" will appear in an upcoming edition of the International Journal of Infectious Diseases and is available online. The paper reviewed an ever-changing body of literature on detection of the novel coronavirus in fecal matter of COVID-19 patients.

"Most of the studies that have been done so far are picking up viral RNA in the feces rather than infectious virus," said E. Susan Amirian, an epidemiologist with Rice's Texas Policy Lab and the study's lead author. "However, a few studies have showed that infectious virus may be present in stool samples."

Amirian said the mere presence of genetic material is less worrisome than if infectious amounts of viable virus are found in stool in future studies, as that would imply it is possible for it to be transmitted to others through feces. She said if future research continues finding viable virus in stool, this could have important implications, especially for those working in the restaurant industry, nursing homes, day cares, etc.

"Ultimately, more research is needed to determine whether exposure to stool is spreading this virus and making the pandemic worse," Amirian said. "But given this possibility, it behooves us to be more careful, especially in settings where people have an increased risk of morbidity and death due to COVID-19."

Amirian said there's no downside to exercising an abundance of caution in following good personal hygiene practices until we know more.

"There are plenty of other diseases out there that are transmitted through fecal contamination, including hepatitis A and norovirus," she said. "Following a high level of precaution will help just in case COVID-19 can be spread this way."