How does Covid-19 survive in gastrointestinal tract so long? | Coursera Community
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How does Covid-19 survive in gastrointestinal tract so long?


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Hello everyone,

Thanks to one of the courses I have taken on Covid-19, I came across these papers:  https://www.thelancet.com/journals/langas/article/PIIS2468-1253(20)30083-2/fulltext 

and this one  https://www.nature.com/articles/s41575-020-0295-7 

for another potential route of transmission via gastrointestinal tract. I read that the active virus was detected for up to 5 weeks in stool samples of certain patients after the patients seemingly had recovered. Could this explain some of the mystery behind the virus perhaps? Could this explain why the number of cases keep on increasing despite the self isolation? 

What do you all think? 


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Denise,  thanks for sharing the two articles.  I have also taken a COVID-19 class and glad to see your posts to gain broader and deeper understanding of this world challenge with this virus.  Now that you mentioned of 5 weeks survival for the virus in GI, it may cause concern for doctors in considering fecal transplant therapy.

Putting that aside, I can see that the virus can survive for this long in GI tract in patients recovered from the infection.  This is because the antibodies would not respond to the virus that is external to our innate immunity system.  Our adaptive immunity system would be triggered when the virus breaks through our innate immunity system.

As for that path of its survival in stool be driving up the infection, I suspect not.  Not social distancing, not wearing face mask,  not diligently doing safe practices are the key contributors, I would surmise.  

Thank you @Denise for sharing this with us. I agree with @ele81946 that the likelihood of this as the reason is doubtful. 
We have only just instituted wearing masks here in the USA. Until now, people could be asymptomatic  and spread it. You could have a conversation with someone who seems perfectly healthy  at your  grocery checkout . The droplets from the conversation could infect you. I am hopeful that if people wear masks,  this would be of tremendous help. 

I have a question about a cloth mask, maybe you can answer? After you take it off, can you just wash it in hot soapy water or must you wash it in a machine? Thanks.

And hand washing seems to still be the best preventative. It’s a good habit for us all the engage in.

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@Judith ,  here are the reasons behind machine wash being a better option, per characteristics of SARS-CoV-2

* The virus is very fragile; the only thing that protects it is a thin outer layer of fat. That is why any soap or detergent is the best remedy, because the foam CUTS the FAT (that is why you have to rub so much: for 20 seconds or more, to make a lot of foam).

By dissolving the fat layer, the protein molecule disperses and breaks down on its own.

* HEAT melts fat; this is why it is so good to use water above 77 degrees Fahrenheit for washing hands, clothes and everything. In addition, hot water makes more foam and that makes it even more useful.

@ele81946 thank you so much for this information. You know so much. Are you in the health/science field?

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@Judith   thanks for being so kind.  I am a learner, trying to fathom what would become when Wuhan was locked down.  My first clue of what was going awry is based on what happened on Diamond Princess, where spread occurred despite lock down exercised on the vessel.  My journey continues with taking courses and participating in discussions to gather facts, data, and science including virology, immunity, epidemiology, W.H.O. best practice in detection, prevention, response and control, contrasting the outcomes using the practices shared by the most successful countries and the most disastrous countries.  Were I not classified as vulnerable, I would have volunteered in the field and gain first hand experiential data.

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Great to see you @ele81946  & @Judith  here again! Thank you so much for your valuable responses. I remember @ele81946 your expertise on gut; I was hoping you’d see this thread too. I am so glad you have done. It’s even more impressive that you have this incredible knowledge and background via studying by yourself. You are such an inspiration @ele81946 .

It’s interesting you mentioned fecal transplantation being on hold. Let’s hope nobody needs that especially during this crisis…

Yes, of course, the social distancing, wearing masks and personal hygiene precautions are the key players against this crisis. In this context (re: gastrointestinal survival of the virus), I was mostly thinking of people living in the same household and carers who may have to look after the toilet needs of the people they care or sharing the same toilet facilities. Similarly in offices or other places that may still be open to share public toilets, one would have to be extra careful. In addition, in the Nature paper, it’s mentioned that baby feces being infected for so long too. So, those who change nappies and those who share the same nappy changing environment either in the same household or in public areas will have to pay extra special attention too.

That is an excellent point you raised up @ele81946 re: innate immunity vs adaptive immunity system. As I have been looking online I’ve come across the fact that how viruses can be sneaky by hiding behind mucus layers: https://academic.oup.com/jid/article/216/1/105/3814252 which causes them to survive the stomach acid. Normally, you would expect stomach acid to kill off most of the virus in a short time. Hiding behind the mucus is one way for them to escape and the other way is if certain people have low levels of acid in their stomachs, they are known to be prone to viral infections too: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676820/ (if you scroll down to pathogenesis section). Hence, it may be good idea if people are taking stomach acid blockers for different reasons, to reduce their intake (if they can, of course, by consulting their doctors on this): https://bmjopen.bmj.com/content/5/12/e010161.full  (infectious gastroenteritis means stomach flu in that paper but it’s showing the evidence on stomach acid blockers and susceptibility to infection).

The other thing to note is that SARS-CoV-2 (the virus behind Covid-19) is thought to use ACE2 as a viral receptor, which is mentioned in the Nature paper. Variations in the ACE2 gene that alter the receptor could make it easier or harder for the virus to get into cells: https://www.nature.com/articles/s41421-020-0147-1 . Here is an easier to read version I came across with via one of my friends: https://www.sciencemag.org/news/2020/03/how-sick-will-coronavirus-make-you-answer-may-be-your-genes . As the title says, part of the answer may be in our genes too…

What do you all think?

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@Judith , I agree with @ele81946  re: masks washing for the reasons he explained. There is another thread on masks if you wish to visit as well: https://coursera.community/health-and-life-sciences-34/covid-19-in-nanoparticles-masks-8359 . 

I appreciate all the knowledge that @Denise a d @ele81946 are sharing here.These are such uncertain times for us all. It is important to know the facts . Thank you to both of you.

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  The reason why faecal transmission may be so long is because the SARS- COV 2 virus  may survive longer in the numerous  gastrointestinal lymph nodes that are feed by ace2 receptors of epithelial cells in the Gastrointestinal tract.  ( the sicker the patient the more likely they are to have virus and slower to get rid of them all. Thanks.

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That’s very interesting @Cleophasd . Thank you for sharing this. What do others think? @ele81946 , @Judith ?

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@Denise thanks for sharing the research that you have done and sharing.  For all the articles that I have come across, SARS-CoV-2 cleverly leverage ACE2 to get into cells and replicate.  Given the fact that it replicates mostly in lung and prolifically there to trigger cytokine storm, I wonder why it did not manifest similarly in the GI tract.  I have much more learning to do.

Meanwhile, I come across this Coronavirus 101 - Focus on Molecular VIrology earlier today and bookmarked it.  The development in so many fronts is amazing!

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@Denise thanks for sharing the research that you have done and sharing.  For all the articles that I have come across, SARS-CoV-2 cleverly leverage ACE2 to get into cells and replicate.  Given the fact that it replicates mostly in lung and prolifically there to trigger cytokine storm, I wonder why it did not manifest similarly in the GI tract.  I have much more learning to do.

Meanwhile, I come across this Coronavirus 101 - Focus on Molecular VIrology earlier today and bookmarked it.  The development in so many fronts is amazing!

Hello, I would like to take a course on COVID-19, where could I do it?

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 Research is still ongoing but I suspect that  the  SARS- Cov 2 virus  survives by hiding in the extensive network of lymph nodes of the gastrointestinal tract.

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@Rose Alvarado   the free course Science Matters: Let's Talk About COVID-19 (taught by Imperial College London) is offered on Coursera.     

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Thank you @Cleophasd for your clarification on the lymph nodes. As @ele81946 stated there is still so much unknown concerning this virus. New discoveries are coming out regularly.

Thank you @ele81946 for highlighting the course from Imperial College. That course was still evolving when I took it. They do have good materials so far but they keep on adding materials as they find new things. Last time I checked Weeks 4 to 8 materials were still missing. In the interim, you could also look at  https://www.futurelearn.com/courses/covid19-novel-coronavirus which is a more complete one. 

@Rose Alvarado I think the other course @ele81946 highlighted is here: https://www.youtube.com/watch?v=8_bOhZd6ieM , it's a free course from youtube. It looks interesting. Thank you @ele81946 for letting us know about it , I will check it out too. 

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Look what I just came across: https://www.independent.ng/coronavirus-can-spread-through-farts-report/ : Could farts spread the virus then? What do you all think?

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It stands to reason that farts from carriers with pants down can spread virus as in the case of carriers cough or sneeze without face mask.  

Separately, for the COVID-19 course on FutureLearn platform, it will start again on May 22 with more updates since early March.  This time, they may just have this funny piece on farts.

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What a long read! To say that I am scared is an understatement. I am trying so hard to remain hopeful. 

I’m inspired by your research and knowledge @ele81946. You sound so much like a health practitioner. Bravo!

Thank you @Denise for starting the thread and for sharing the numerous articles.

 

Please does anyone know if the virus mutates?

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@Terry   thanks for your kind words.   Be hopeful as I believe all these shall come to pass.  It will take time as scientists around the world are collaborating and competing at the same time to play with the card dealt by Mother nature.      

As for mutation, yes, SARS-CoV-2 is no exception.  There are at least three main variants in China, Europe and America per genetic study shown in this article.  

 

Be safe, healthy and calm.   Encourage others to do the same.  If anyone feels overwhelmed, I would recommend listening to TED Connect interview of Elizabeth Gilbert.  She is marvelous, incredibly wise and calming.

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Thank you too @ele81946 for the words of encouragement, the article and the recommendation. You are far too kind. 🤗😊💐

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Thank you for the question @Terry on virus mutation and @ele81946 for the comprehensive answer once again. :clap:  

One more thing to remember on the mutation side is that: in general, the virus does not wish to kill its host. Although there have been worries of more aggressive form of the virus, hopefully it will be the other way around like influenza viruses, it will get milder and milder with mutations over time. 

Thank you @ele81946 for highlighting that course starting in May 22 in FutureLearn as well. Yes, hopefully there will be more data by then for more reliable information.

Who knew our underwear could act as protective masks against farts spreading virus?!! :grinning:  We learn something new everyday especially on the Covid-19 ear now! :sweat_smile:

What do you all think? 

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Oh that’s good to know. Thank you for the information @Denise.

Wow! Underwear? Any fabric or cotton specifically? Knowledge is power! A millions thanks, Denise.

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That’s so true @Terry  , knowledge is power indeed. Thank you for reminding us that.

I am guessing what fabric of underwear would be under investigation now as well. Here is an interesting article explaining a bit more on farts and Coronavirus: https://www.forbes.com/sites/brucelee/2020/04/27/can-farts-transmit-covid-19-coronavirus-here-is-what-is-being-said/  

If others have more to share on these topics, please feel free to contribute. Thanks. 

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