# Prevalence of SARS-CoV-2 virus in saliva, stool, and urine samples of COVID-19 patients in Bihar, India

## TL;DR

This study found that SARS-CoV-2 virus is commonly present in saliva, stool, and urine samples of COVID-19 patients in Bihar, India.

## Contribution

The study provides evidence of SARS-CoV-2 presence in non-respiratory samples, highlighting potential feco-oral transmission risks.

## Key findings

- 74.8% of 143 COVID-19 cases tested positive for SARS-CoV-2 RNA in at least one non-respiratory sample.
- Saliva, stool, and urine samples were all found to contain SARS-CoV-2 RNA.
- The high prevalence suggests possible feco-oral transmission routes and implications for public health.

## Abstract

Introduction. The coronavirus illness caused by SARS-CoV-2 can cause multiple organ involvement, with varying degrees of severity. Besides inhalation as a route for transmission, feco-oral has also been proposed. Its transmission to sewage systems is a growing public health issue.

Objective. To detect SARS-CoV-2 RNA in non-respiratory samples (saliva, urine, and stool) collected from COVID-19 cases, in Bihar.

Methods. This cross-sectional observational study was conducted from January 2021 to March 2022 on human non-respiratory samples. A total of 345 samples including saliva (116), stool (97), and urine (132) were collected from 143 COVID-19 cases. Samples were analysed for SARS-CoV-2 by multiplex RT-PCR targeted against E, ORF 1ab, and RdRp genes.

Results. In this study, out of 143 cases, a total of 107 (74.8 %) were positive for SARS-CoV-2 RNA in at least one of the non-respiratory samples.

Conclusion. There is a high prevalence of SARS-CoV-2 virus in non-respiratory samples.