tetano
Editor, Senior Moderator
Gastroenterol Hepatol
. 2022 Jan 22;S0210-5705(22)00001-2.
doi: 10.1016/j.gastrohep.2021.12.009. Online ahead of print.
High prevalence of SARS-CoV-2 detection and prolonged viral shedding in stools: A Systematic Review and Cohort Study
[Article in English, Spanish]
Luis Antonio Díaz[SUP] 1 [/SUP], Tamara García-Salum[SUP] 2 [/SUP], Eduardo Fuentes-López[SUP] 3 [/SUP], Diego Reyes[SUP] 4 [/SUP], Javier Ortiz[SUP] 4 [/SUP], Javier Chahuan[SUP] 1 [/SUP], Jorge Levican[SUP] 2 [/SUP], Leonardo I Almonacid[SUP] 2 [/SUP], Gonzalo H Valenzuela[SUP] 2 [/SUP], Eileen Serrano[SUP] 2 [/SUP], Sigall Budnik[SUP] 5 [/SUP], Vicente Gandara[SUP] 5 [/SUP], Andrea Gallardo[SUP] 5 [/SUP], María Francisca Seydewitz[SUP] 5 [/SUP], Marcela Ferrés[SUP] 2 [/SUP], Colomba Cofré[SUP] 6 [/SUP], Manuel Álvarez[SUP] 1 [/SUP], Carolina Pavez[SUP] 1 [/SUP], Roberto Candia[SUP] 1 [/SUP], Hugo Monrroy[SUP] 1 [/SUP], Alberto Espino[SUP] 1 [/SUP], Gabriel Rada[SUP] 7 [/SUP], Luis Ortiz[SUP] 8 [/SUP], Sebastián Valderrama[SUP] 4 [/SUP], Erick Salinas[SUP] 2 [/SUP], Adriana Toro[SUP] 9 [/SUP], Marcos Ortega[SUP] 10 [/SUP], Margarita Pizarro[SUP] 1 [/SUP], Rafael A Medina[SUP] 11 [/SUP], Arnoldo Riquelme[SUP] 12 [/SUP]
Affiliations
Abstract
Objectives: To: 1. Describe the frequency of viral RNA detection in stools in a cohort of patients infected with SARS-CoV-2, and 2. Perform a systematic review to assess the clearance time in stools of SARS-CoV-2.
Methods: We conducted a prospective cohort study in two centers between March-May 2020. We included SARS-CoV-2 infected patients of any age and severity. We collected seriated nasopharyngeal swabs and stool samples to detect SARS-CoV-2. After, we performed a systematic review of the prevalence and clearance of SARS-CoV-2 in stools (PROSPERO-ID: CRD42020192490). We estimated prevalence using a random-effects model. We assessed clearance time by using Kaplan-Meier curves.
Results: We included 32 patients; mean age was 43.7;17.7 years, 43.8% were female, and 40.6% reported gastrointestinal symptoms. Twenty-five percent (8/32) of patients had detectable viral RNA in stools. The median clearance time in stools of the cohort was 11[10-15] days. Systematic review included 30 studies (1,392 patients) with stool samples. Six studies were performed in children and 55% were male. The pooled prevalence of viral detection in stools was 34.6% (twenty-four studies, 1,393 patients; 95%CI:25.4-45.1); heterogeneity was high (I2:91.2%, Q:208.6; p=<0.001). A meta-regression demonstrates an association between female-gender and lower presence in stools (p=0.004). The median clearance time in stools was 22 days (nineteen studies, 140 patients; 95%CI:19-25). After 34 days, 19.9% (95%CI:11.3-29.7) of patients have a persistent detection in stools.
Conclusions: Detection of SARS-CoV-2 in stools is a frequent finding. The clearance of SARS-CoV-2 in stools is prolonged and it takes longer than nasopharyngeal secretions.
Keywords: 2019-nCoV-2; COVID-19; Diarrhea; SARS-CoV-2; coronavirus; novel coronavirus.
. 2022 Jan 22;S0210-5705(22)00001-2.
doi: 10.1016/j.gastrohep.2021.12.009. Online ahead of print.
High prevalence of SARS-CoV-2 detection and prolonged viral shedding in stools: A Systematic Review and Cohort Study
[Article in English, Spanish]
Luis Antonio Díaz[SUP] 1 [/SUP], Tamara García-Salum[SUP] 2 [/SUP], Eduardo Fuentes-López[SUP] 3 [/SUP], Diego Reyes[SUP] 4 [/SUP], Javier Ortiz[SUP] 4 [/SUP], Javier Chahuan[SUP] 1 [/SUP], Jorge Levican[SUP] 2 [/SUP], Leonardo I Almonacid[SUP] 2 [/SUP], Gonzalo H Valenzuela[SUP] 2 [/SUP], Eileen Serrano[SUP] 2 [/SUP], Sigall Budnik[SUP] 5 [/SUP], Vicente Gandara[SUP] 5 [/SUP], Andrea Gallardo[SUP] 5 [/SUP], María Francisca Seydewitz[SUP] 5 [/SUP], Marcela Ferrés[SUP] 2 [/SUP], Colomba Cofré[SUP] 6 [/SUP], Manuel Álvarez[SUP] 1 [/SUP], Carolina Pavez[SUP] 1 [/SUP], Roberto Candia[SUP] 1 [/SUP], Hugo Monrroy[SUP] 1 [/SUP], Alberto Espino[SUP] 1 [/SUP], Gabriel Rada[SUP] 7 [/SUP], Luis Ortiz[SUP] 8 [/SUP], Sebastián Valderrama[SUP] 4 [/SUP], Erick Salinas[SUP] 2 [/SUP], Adriana Toro[SUP] 9 [/SUP], Marcos Ortega[SUP] 10 [/SUP], Margarita Pizarro[SUP] 1 [/SUP], Rafael A Medina[SUP] 11 [/SUP], Arnoldo Riquelme[SUP] 12 [/SUP]
Affiliations
- PMID: 35077722
- DOI: 10.1016/j.gastrohep.2021.12.009
Abstract
Objectives: To: 1. Describe the frequency of viral RNA detection in stools in a cohort of patients infected with SARS-CoV-2, and 2. Perform a systematic review to assess the clearance time in stools of SARS-CoV-2.
Methods: We conducted a prospective cohort study in two centers between March-May 2020. We included SARS-CoV-2 infected patients of any age and severity. We collected seriated nasopharyngeal swabs and stool samples to detect SARS-CoV-2. After, we performed a systematic review of the prevalence and clearance of SARS-CoV-2 in stools (PROSPERO-ID: CRD42020192490). We estimated prevalence using a random-effects model. We assessed clearance time by using Kaplan-Meier curves.
Results: We included 32 patients; mean age was 43.7;17.7 years, 43.8% were female, and 40.6% reported gastrointestinal symptoms. Twenty-five percent (8/32) of patients had detectable viral RNA in stools. The median clearance time in stools of the cohort was 11[10-15] days. Systematic review included 30 studies (1,392 patients) with stool samples. Six studies were performed in children and 55% were male. The pooled prevalence of viral detection in stools was 34.6% (twenty-four studies, 1,393 patients; 95%CI:25.4-45.1); heterogeneity was high (I2:91.2%, Q:208.6; p=<0.001). A meta-regression demonstrates an association between female-gender and lower presence in stools (p=0.004). The median clearance time in stools was 22 days (nineteen studies, 140 patients; 95%CI:19-25). After 34 days, 19.9% (95%CI:11.3-29.7) of patients have a persistent detection in stools.
Conclusions: Detection of SARS-CoV-2 in stools is a frequent finding. The clearance of SARS-CoV-2 in stools is prolonged and it takes longer than nasopharyngeal secretions.
Keywords: 2019-nCoV-2; COVID-19; Diarrhea; SARS-CoV-2; coronavirus; novel coronavirus.
