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ORIGINAL RESEARCH article

Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1417967

Longitudinal Fecal Shedding of SARS-CoV-2, Pepper Mild Mottle Virus, and Human Mitochondrial DNA in COVID-19 Patients

Provisionally accepted
Pengbo Liu Pengbo Liu 1,2*Orlando I. Sablon Orlando I. Sablon 1,2Yuke Wang Yuke Wang 1Stephen P. Hilton Stephen P. Hilton 1,2Lana Khalil Lana Khalil 1Jessica M. Ingersoll Jessica M. Ingersoll 3Jennifer Truell Jennifer Truell 3Sri Edupuganti Sri Edupuganti 3Ghina Alaaeddine Ghina Alaaeddine 3Amal Naji Amal Naji 3Eduardo Monarrez Eduardo Monarrez 3Marlene Wolfe Marlene Wolfe 4Nadine Rouphael Nadine Rouphael 3Colleen Kraft Colleen Kraft 3Christine Moe Christine Moe 4*
  • 1 Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, United States
  • 2 Emory University, Atlanta, Georgia, United States
  • 3 School of Medicine, Emory University, Atlanta, Georgia, United States
  • 4 Rollins School of Public Health, Emory University, Atlanta, Georgia, United States

The final, formatted version of the article will be published soon.

    Since the coronavirus disease 2019 (COVID-19) pandemic, wastewater-based epidemiology (WBE) has been widely applied in many countries and regions for monitoring COVID-19 transmission in the population through testing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in wastewater. However, the amount of virus shed by individuals over time based on the stage of infection and accurate number of infections in the community creates challenges in predicting COVID-19 prevalence in the population and interpreting WBE results. In this study, we measured SARS-CoV-2, pepper mild mottle virus (PMMoV), and human mitochondrial DNA (mtDNA) in longitudinal fecal samples collected from 42 COVID-19 patients for up to 42 days after diagnosis. SARS-CoV-2 RNA was detected in 73.1% (19/26) of inpatient study participants in at least one of the collected fecal specimens during the sampling period. Most participants shed the virus within three weeks after diagnosis, but five inpatient participants still shed the virus between 20 and 60 days after diagnosis.The median concentration of SARS-CoV-2 in positive fecal samples was 1.08x10 5 genome copies (GC)/gram dry fecal material. PMMoV and mtDNA were detected in 99.4% (154/155) and 100% (155/155) of all fecal samples, respectively. The median concentrations of PMMoV RNA and mtDNA in fecal samples were 1.73x10 7 and 2.49x10 8 GC/dry gram, respectively. These results provide important information about the dynamics of fecal shedding of SARS-CoV-2 and two human fecal indicators in COVID-19 patients. mtDNA showed higher positive rates, higher concentrations, and less variability between and within individuals than PMMoV, suggesting that mtDNA could be a better normalization factor for WBE results than PMMoV.

    Keywords: SARS-CoV-2, COVID-19, Longitudinal, Fecal shedding, PMMoV, mtDNA

    Received: 15 Apr 2024; Accepted: 28 Aug 2024.

    Copyright: © 2024 Liu, Sablon, Wang, Hilton, Khalil, Ingersoll, Truell, Edupuganti, Alaaeddine, Naji, Monarrez, Wolfe, Rouphael, Kraft and Moe. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Pengbo Liu, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, United States
    Christine Moe, Rollins School of Public Health, Emory University, Atlanta, 30322, Georgia, United States

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