Clinical features and sexual transmission potential of SARS-CoV-2 infected female patients: a descriptive study in Wuhan, China

Background：As of February 26, 2020, SARS-CoV-2 has infected more than 78190 people and caused 2718 deaths in China. This virus rapidly spreads to 33 countries worldwide. Thus, in order to effectively block its transmission, it is urgent to uncover all of the possible transmission routes of SARS-CoV-2. Methods：From January 28 to February 18, 2020, 35 female patients diagnosed with COVID-19 in Tongji Hospital were included in this descriptive study. The gynecologic history, clinical characteristics, laboratory findings and chest computed tomography (CT) of all patients were recorded in detail. To examine whether there is sexual transmission, we employed real-time polymerase chain reaction testing (RT-PCR) to detect SARS-CoV-2 in vaginal environment (including vaginal discharge, cervical or vaginal residual exfoliated cells) and anal swab samples, and inquired recent sexual behaviors from the patients. Findings：The average age of the 35 patients with COVID-19 was 61.5 years old (SD =11.2). Over 50% patients infected with SARS-CoV-2 had chronic diseases. We tested the vaginal environment and anal swabs from the 35 female patients with COVID-19, and found that only an anal swab sample from one patient was positive for SARS-CoV-2. All the samples from vaginal environment were negative for SARS-CoV-2. Additionally, two female patients had sex with their partners during a possible SARS-CoV-2 infection incubation period, while one patient's partner was uninfected and the other patient's partner was diagnosed with COVID-19 (after the diagnosis of the female patient). Interpretation: The results from this study show no evidence of sexual transmission of SARS-CoV-2. No positive RT-PCR result was found in the vaginal environment perhaps due to the lack of ACE2 expression, which is the receptor of SARS-CoV-2, in the vagina and cervix tissues (human protein atlas).