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00925njm 22002777a 4500 dc Cerrada-Romero, Cristina author Berastegui-Cabrera, Judith author Camacho-Martínez, Pedro author Goikoetxea-Aguirre, Josune author Pérez-Palacios, Patricia author Santibáñez, Sonia author Blanco-Vidal, María José author Valiente, Adoración author Alba, Jorge author Rodríguez-Álvarez, Regino author Pascual, Álvaro author Oteo, José A author Cisneros, José Miguel author Pachón, Jerónimo author Casas Flecha, Inmaculada author Cordero, Elisa author Pozo Sanchez, Francisco author Sánchez-Céspedes, Javier author 2022-05-05 The main objective was to evaluate the viability of the SARS-CoV-2 viral particles excreted in stools. In addition, we aimed to identify clinical factors associated with the detection of SARS-CoV-2 RNA in feces, and to determine if its presence is associated with an unfavorable clinical outcome, defined as intensive care unit (ICU) admission and/or death. A prospective multicenter cohort study of COVID-19 adult patients, with confirmed SARS-CoV-2 infection by RT-PCR assay in nasopharyngeal (NP) swabs admitted to four hospitals in Spain, from March 2020 to February 2021. Sixty-two adult COVID-19 patients had stool samples collected at admission and/or during the follow up, with a total of 79 stool samples. SARS-CoV-2 RNA was detected in stool samples from 27 (43.5%) out of the 62 patients. Replicative virus, measured by the generation of cytopathic effect in cell culture and subsequent RT-PCR confirmation of a decrease in the Ct values, was not found in any of these stool samples. Fecal virus excretion was not associated with the presence of gastrointestinal symptoms, or with differences in the evolution of COVID-19 patients. Our results suggest that SARS-CoV-2 replicative capacity is null or very limited in stool samples, and thus, the fecal-oral transmission of SARS-CoV-2 as an alternative infection route is highly unlikely. In our study, the detection of SARS-CoV-2 RNA in feces at the beginning of the disease is not associated with any clinical factor nor with an unfavorable clinical outcome. Sci Rep. 2022 May 5;12(1):7397. 10.1038/s41598-022-11439-7 2045-2322 Scientific Reports 35513481 http://hdl.handle.net/20.500.12105/14853 Excretion and viability of SARS-CoV-2 in feces and its association with the clinical outcome of COVID-19