{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:33:56Z","timestamp":1790220836340,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T00:00:00Z","timestamp":1595808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Severe acute respiratory syndrome coronavirus 2 (SARS\u2010CoV\u20102) RNA was found in the intestines and feces, but its clinical significance is not completely clear. We aim to characterize the longitudinal test results of SARS\u2010CoV\u20102 RNA in anal swabs and to explore the association with disease severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included laboratory\u2010confirmed coronavirus disease 2019 (COVID\u201019) patients, who were hospitalized in Guangzhou Eighth People's Hospital and excluded those who had not received anal swabs for SARS\u2010COV\u20102 RNA testing. Epidemiological, clinical, and laboratory data were obtained. Throat swabs and anal swabs were collected periodically for SARS\u2010COV\u20102 RNA detection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and seventeen eligible patients (median aged 50 years, 50.2% were females) were analyzed. 21.2% (46\/217) of the patients were detected with SARS\u2010CoV\u20102 RNA in anal swabs. The duration of viral RNA was longer, but the viral load was lower in anal swabs than throat swabs in the early stage of the disease. During a median follow\u2010up of 20 days, 30 (13.8%) patients were admitted to the intensive care unit (ICU) for high\u2010flow nasal cannula or higher\u2010level oxygen support measures to correct hypoxemia. Detectable viral RNA in anal swabs (adjusted hazard ratio [aHR], 2.50; 95% confidence interval [CI], 1.20\u20105.24), increased C\u2010reactive protein (aHR, 3.14; 95% CI, 1.35\u20107.32) and lymphocytopenia (aHR, 3.12; 95% CI, 1.46\u20106.67) were independently associated with ICU admission. The cumulative incidence of ICU admission was higher among patients with detectable viral RNA in anal swabs (26.3% vs 10.7%, <jats:italic>P<\/jats:italic>\u2009=\u2009.006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Detectable SARS\u2010CoV\u20102 RNA in the digestive tract was a potential warning indicator of severe disease.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmv.26307","type":"journal-article","created":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T14:33:30Z","timestamp":1594910010000},"page":"794-802","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Association between detectable SARS\u2010COV\u20102 RNA in anal swabs and disease severity in patients with coronavirus disease 2019"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3262-1760","authenticated-orcid":false,"given":"Weiyin","family":"Lin","sequence":"first","affiliation":[{"name":"Infectious Disease Center, Guangzhou Eighth People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7302-4132","authenticated-orcid":false,"given":"Zhiwei","family":"Xie","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Guangzhou Eighth People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueping","family":"Li","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Guangzhou Eighth People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liya","family":"Li","sequence":"additional","affiliation":[{"name":"Institute of Infectious Diseases, Guangzhou Eighth People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Wen","sequence":"additional","affiliation":[{"name":"Infectious Disease Center, Guangzhou Eighth People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Cao","sequence":"additional","affiliation":[{"name":"Infectious Disease Center, Guangzhou Eighth People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoting","family":"Chen","sequence":"additional","affiliation":[{"name":"Infectious Disease Center, Guangzhou Eighth People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Ou","sequence":"additional","affiliation":[{"name":"Infectious Disease Center, Guangzhou Eighth People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengyu","family":"Hu","sequence":"additional","affiliation":[{"name":"Institute of Infectious Diseases, Guangzhou Eighth People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Li","sequence":"additional","affiliation":[{"name":"Institute of Infectious Diseases, Guangzhou Eighth People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoping","family":"Tang","sequence":"additional","affiliation":[{"name":"Institute of Infectious Diseases, Guangzhou Eighth People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiping","family":"Cai","sequence":"additional","affiliation":[{"name":"Infectious Disease Center, Guangzhou Eighth People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linghua","family":"Li","sequence":"additional","affiliation":[{"name":"Infectious Disease Center, Guangzhou Eighth People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,27]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"WHO. 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