Virtual Trip (Greece)

Abstract BackgroundHow SARS-CoV-2 is transmitted is of key public health importance. SARS-CoV-2 has been detected in the feces of some Covid-19 patients which suggests the possibility that the virus could additionally be transmitted via the orofecal route.MethodsThis review is part of an Open Evidence Review on Transmission Dynamics of Covid-19. We conduct ongoing searches using LitCovid, medRxiv, Google Scholar and Google for Covid-19; assess study quality based on five criteria and report important findings on an ongoing basis. Where necessary authors are contacted for further details or clarification on the content of their articles.ResultsWe found 59 studies: nine reviews and 51 primary studies or reports (one cohort study also included a review) examining the potential role of orofecal transmission of SARS-CoV-2. Half (n=29) were done in China. Thirty seven studies reported positive fecal samples for SARS-CoV-2 based on RT-PCR results (n=1,034 patients). Six studies reported isolating the virus from fecal samples of nine patients, one study isolated the virus from rectal tissue and one laboratory study found that SARS-CoV-2 productively infected human small intestinal organoids. Eleven studies report on fecal samples found in sewage, and two sampled bathrooms and toilets.ConclusionsVarious observational and mechanistic evidence support the hypothesis that SARS-CoV-2 can infect and be shed from the human gastrointestinal tract. Policy should emphasize the importance of strict personal hygiene measures, and chlorine-based disinfection of surfaces in locations where there is presumed or known SARS-CoV-2 activity.

Two modifications to the standard use of receiver operating characteristic (ROC) curves for evaluating virtual screening methods are proposed. The first is to replace the linear plots usually used with semi-logarithmic ones (pROC plots), including when doing "area under the curve" (AUC) calculations. Doing so is a simple way to bias the statistic to favor identification of "hits" early in the recovery curve rather than late. A second suggested modification entails weighting each active based on the size of the lead series to which it belongs. Two weighting schemes are described: arithmetic, in which the weight for each active is inversely proportional to the size of the cluster from which it comes; and harmonic, in which weights are inversely proportional to the rank of each active within its class. Either scheme is able to distinguish biased from unbiased screening statistics, but the harmonically weighted AUC in particular emphasizes the ability to place representatives of each class of active early in the recovery curve.