High prevalence of SARS-CoV-2 detection and prolonged viral shedding in stools: A systematic review and cohort study

Diaz, Luis Antonio; Garcia-Salum, Tamara; Fuentes-López, Eduardo; Reyes, Diego; Ortiz, Javier; Chahuan, Javier; Levican, Jorge; Almonacid, Leonardo, I; Valenzuela, Gonzalo H.; Serrano, Eileen; Budnik, Sigall; Gándara, Vicente; Gallardo, Andrea; Seydewitz, María Francisca; Ferrés, Marcela; et. al.

Keywords: diarrhea, Coronavirus, COVID-19, SARS-CoV-2, 2019-nCoV-2, Novel coronavirus


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 and 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 (1392 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, 1393 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.

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Fecha de publicación: 2022
Página de inicio: 1
Página final: 12
Idioma: English
URL: https://doi.org/10.1016/j.gastrohep.2021.12.009
Notas: WOS, ISI