Persistent Symptoms of COVID-19: Molecular Tests by Nasal and Pharyngeal Swabs Do Not Detect the Presence of the Virus in Intestines, Heart, and Other Organs

The paper titled “Persistent Symptoms of COVID-19: Molecular Tests by Nasal and Pharyngeal Swabs Do Not Detect the Presence of the Virus in Intestines, Heart, and Other Organs” addresses the limitations of PCR tests in detecting SARS-CoV-2 in various parts of the body.

Here’s a detailed summary:

Key Message: The paper emphasizes that a negative PCR result, obtained from nasal and pharyngeal swabs, does not confirm the absence of SARS-CoV-2 in other parts of the body or at the intracellular level. It specifically highlights that the virus can persist in organs like the intestines, heart, and skin, even when respiratory tract samples test negative​​.

Virus Location Beyond Respiratory Tract: The paper underscores that SARS-CoV-2 is often found in the intestines, with studies showing virus detection in anal smears and stool samples in 25-50% of COVID-19 patients. It also mentions the presence of the virus in the endothelium of blood vessels and the skin, as evidenced by skin biopsies in patients with chilblains or perniosis type lesions​​.

Extrapulmonary Presence: The paper cites autopsies of COVID-19 deceased patients, revealing the presence of viral RNA in the heart, liver, kidneys, brain, pericardium, gonads, mastoid bone, and middle ear. This indicates that the virus affects multiple organ systems beyond the respiratory tract​​.

Persistence of the Virus: Contrary to initial beliefs that the virus does not persist for more than two weeks in the human body, the paper states that in severe and critical COVID-19 cases, a high viral load can persist in various organs for weeks. This necessitates continued treatment to reduce the viral load in the body​​.

Inadequacy of Nasal and Pharyngeal Swabs Alone for Diagnosis: For patients with persistent symptoms of COVID-19, the paper argues that relying solely on molecular tests via nasal and pharyngeal swabs is insufficient. It suggests that when such tests return negative, they only indicate a lack of sufficient viral load in upper airway secretions and do not account for viral presence in other organs or intracellularly​​.

Persistent Symptoms and Viral Etiology: The paper discusses the correlation between persistent COVID-19 symptoms and the ongoing presence of the virus in the body. It references a study where the majority of patients with persistent or post-acute symptoms responded favorably to treatments aimed at reducing viral load, supporting the notion that these symptoms are linked to the continued presence of SARS-CoV-2​​.

COVID-19 as a Multi-Organ Disease: Finally, the paper highlights that COVID-19 frequently affects multiple organs, thus necessitating tests using samples from other locations besides the upper airways. This is especially true weeks after infection onset when the viral load in the upper airways diminishes compared to other locations. The paper stresses that this is an important consideration for accurately diagnosing persistent COVID-19​​.

Overall, the paper calls for a broader approach to diagnosing and understanding COVID-19, especially in cases with persistent symptoms, emphasizing the need to consider the presence of the virus in multiple organs and systems beyond the respiratory tract.

Read More:

Leave a comment