SARS-CoV-2: Potential feco-oral transmission and implications on the spread and severity of COVID-19 in Venezuela. Mini-review

Abstract

The recognized human-to-human transmission of SARS-CoV-2 is through respiratory droplets and contact with contaminated surfaces. However, the high transmissibility of the virus and the pattern of symptoms of COVID-19 suggest the likelihood of other forms of spread. Increasing evidence suggests that SARS‐CoV‐2 could be transmitted by the feco‐oral route. SARS-CoV-2 is known to infect gastrointestinal epithelial cells and a significant number of infected people have gastrointestinal symptoms. Viable viruses, viral RNA, and prolonged shedding of viral RNA have been detected in the feces of COVID-19 patients. The virus has been found in sewage and surface waters of several countries. The possible feco-oral transmission of SARS-CoV-2 could be significant in low-income countries. High poverty levels and the collapse of health and other public services might increase the risk of Venezuelans to suffer a more devastating impact from COVID-19 than other populations. In conclusion, the feco-oral transmission of SARS-CoV-2 has not been demonstrated. However, it is conceivable and the impact of COVID-19 could be high in low-income countries, especially in Venezuela due to its humanitarian crisis. The lack of information on the viability and infectivity of the virus in wastewaters and surface waters and the risk of transmission of the infection are important gaps in knowledge that deserve further investigation.