Persistent coronaviral particles in the gut

flitza

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I just read this article: https://hms.harvard.edu/news/covid-19s-gut-connection and naturally was intrigued by the demonstration of persistent Covid viral particles in the gut. The work is fantastic! They demonstrated persistent viral particles in the guts of children who got the MIS-C syndrome following Covid infection. In case you're not familiar, it is a terrible complication often leading to severe cardiac and other organ involvement in kids, thankfully in less than 1% of kids infected. The etiology was unknown. Now they have not only elucidated the pathophysiology, that the persistent viral particles cause a kind of leaky gut thing, but have proposed and are trialing a med that can work to block the substance, zonulin that closes the junctions in the gut.
Anyway, as I said, this is just fantastic news for these children. In addition, it brings to mind the idea that there are likely persistent viral particles in the guts of ME patients ( a la Chia and Proal) and the notion that perhaps this treatment might help some of us as well.
 

Pyrrhus

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Very interesting- thanks for sharing this!

It is also interesting to note that coronavirus persistence in the intestines was first reported by Chinese researchers very early on in the SARS-CoV-2 pandemic:

Persistence of intestinal SARS-CoV-2 infection in patients with COVID-19 leads to re-admission after pneumonia resolved (Wang et al., April 2020)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184976/

Excerpt:
Wang et al 2020 said:
The current reports of COVID-19 focus on the respiratory system, however, intestinal infections caused by SARS-CoV-2 are also worthy of attention. This paper reported persistence of intestinal SARS-CoV-2 infection leads to re-admission after pneumonia resolved in three cases with COVID-19.
 

Pyrrhus

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Another paper that describes coronavirus persistence in the intestines:

Evolution of antibody immunity to SARS-CoV-2 (Gaebler et al., January 2021)
https://www.nature.com/articles/s41586-021-03207-w

Excerpt:
Gaebler et al 2021 said:
We find that titres of IgM and IgG antibodies against the receptor-binding domain (RBD) of the spike protein of SARS-CoV-2 decrease significantly over [6.2 months after infection], with IgA being less affected.
[...]
By contrast, the number of RBD-specific memory B cells remains unchanged at 6.2 months after infection.
[...]
Immunofluorescence and PCR analyses of intestinal biopsies obtained from asymptomatic individuals at 4 months after the onset of coronavirus disease 2019 (COVID-19) revealed the persistence of SARS-CoV-2 nucleic acids and immunoreactivity in the small bowel of 7 out of 14 individuals.
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Pyrrhus

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Related discussion:

SARS-Cov-2 Persists In Intestinal Enterocytes Up To 7 Months After Symptom Resolution (Tokuyama et al., March 2021)
https://forums.phoenixrising.me/thr...p-to-7-months-after-symptom-resolution.84932/

Excerpt:
Tokuyama et al. 2021 said:
Viral RNA has been isolated from fecal samples from COVID-19 patients, where it can persist longer than detection in nasopharyngeal swabs.
[...]
Small intestinal biopsies from patients who underwent clinically indicated endoscopic procedures after a positive SARS-COV-2 nasopharyngeal swab (n=27) or were found to have positive serology (n=2) were analyzed by immunofluorescence (IF) (n=25) and electron microscopy (EM) (n=14) for the presence of virus.
[...]
Sixteen of 29 patients had detectable SARS-CoV-2 antigen by either IF or EM (Figure 1). Virus was restricted to the epithelium and patchy in distribution. Virus was detected as soon as 15 days after symptom onset and persisted up to 6 months after symptom resolution.
[...]
Despite the presence of virus, only 9/16 patients had any signs of inflammation on histology, and when present, this was mild.
[...]
Interestingly, only 37.5% (6 of 16) of patients with virus detected in the small bowel had GI symptoms (diarrhea, nausea or vomiting) during their acute COVID-19 illness as compared to 46.1% (6/13) of patients where no virus could be detected in the intestines.
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Pyrrhus

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Related discussion:

Residual SARS-CoV-2 viral antigens detected in GI and hepatic tissues from five recovered patients with COVID-19 (Cheung et al., June 2021)
https://forums.phoenixrising.me/threads/gut-persistence-of-c19-up-to-180-days.85492/

Excerpt:
Cheung et al. 2021 said:
Using conventional immunohistochemistry, we detected SARS-CoV-2 nucleocapsid protein (NP) in the colon, appendix, ileum, haemorrhoid, liver, gallbladder and lymph nodes (figure 1A–K) from five patients who recovered from COVID-19, ranging from 9 to 180 days after testing negative for SARS-CoV-2.
[...]
Validating our findings, we detected SARS-CoV-2 spike protein (figure 1L–P) and RNA (figure 2B–F) in the above-mentioned tissues using conventional immunohistochemistry and RNAscope, respectively.
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Pyrrhus

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Another publication finds coronavirus persistence in the gastrointestinal tract!

SARS-CoV-2 identified by transmission electron microscopy in lymphoproliferative and ischaemic intestinal lesions of COVID-19 patients with acute abdominal pain: two case reports (Martin-Cardona et al., August 2021)
https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-021-01905-3

Excerpt:
Martin-Cardona et al. 2021 said:
Transmission electron microscopy (TEM) is a useful tool that provides an understanding of SARS-CoV-2 invasiveness, replication and dissemination in body cells but information outside the respiratory tract is very limited. We report two cases of severe intestinal complications (intestinal lymphoma and ischaemic colitis) in which the presence of SARS-CoV-2 in intestinal tissue was confirmed by TEM. These are the first two cases reported in the literature of persistence of SARS-CoV-2 demonstrated by TEM in intestinal tissue after COVID 19 recovery and SARS-CoV-2 nasopharyngeal clearance.
[...]
The first case presented as an ileocaecal inflammatory mass which turned to be a B-cell lymphoma. Viral particles were found in the cytoplasm of endothelial cells of damaged mucosa. In situ hybridization was negative in tumour cells, thus ruling out an oncogenic role for the virus. SARS-CoV-2 remained in intestinal tissue 6 months after nasopharyngeal clearance, suggesting latent infection. The second patient had a severe ischaemic colitis with perforation and SARS-CoV-2 was also identified in endothelial cells.
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Nuno

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Pyrrhus

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A new case report:

Persistent SARS-CoV-2 Nucleocapsid Protein Presence in the Intestinal Epithelium of a Pediatric Patient 3 Months After Acute Infection (Arostegui et al., 2022)
https://journals.lww.com/jpgnr/Fulltext/2022/02000/Persistent_SARS_CoV_2_Nucleocapsid_Protein.9.aspx

Excerpt:
In addition to the severe impact of acute respiratory disease during the SARS-CoV-2 pandemic, the issue of “Long COVID” illness has impacted large numbers of patients following the initial infection. Wide ranges of Long Covid incidence have been reported, ranging from 30 to 87%. Long COVID has a variety of clinical manifestations, including gastrointestinal symptoms. Here, we report a case of persistent abdominal pain, 3 months following a SARS-CoV-2 diagnosis, associated with chronic colonic inflammation and the presence of mucosal SARS-CoV-2 virions.
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Pyrrhus

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Another one!

Gastrointestinal symptoms and fecal shedding of SARS-CoV-2 RNA suggest prolonged gastrointestinal infection (Natarajan et al., 2022)
https://doi.org/10.1016/j.medj.2022.04.001


Highlights:
  • 1. Approximately half of COVID-19 patients shed fecal RNA in the week after infection
  • 2. 4% patients with COVID-19 shed fecal viral RNA 10 months after diagnosis.
  • 3. Presence of fecal SARS-CoV-2 RNA is associated with gastrointestinal symptoms.
  • 4. SARS-CoV-2 likely infects gastrointestinal tissue.

Graphical Abstract:
1649899570886.png
 

Pyrrhus

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