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

Autor: Díaz LA; Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., García-Salum T; Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Fuentes-López E; Department of Health Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Reyes D; Department of Internal Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Ortiz J; Department of Internal Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Chahuan J; Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Levican J; Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Almonacid LI; Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Valenzuela GH; Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Serrano E; Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Budnik S; School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Gandara V; School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Gallardo A; School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Seydewitz MF; School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Ferrés M; Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Cofré C; Department of Pediatric Gastroenterology and Nutrition, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Álvarez M; Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Pavez C; Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Candia R; Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Monrroy H; Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Espino A; Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Rada G; Department of Internal Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile; Epistemonikos Foundation, Santiago, Chile., Ortiz L; Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile., Valderrama S; Department of Internal Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Salinas E; Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Toro A; Pediatric Service, Clínica UC San Carlos, Red Salud UC Christus, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Ortega M; Department of Intensive Care Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Respiratory Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Pizarro M; Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Medina RA; Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address: rmedinai@uc.cl., Riquelme A; Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Health Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address: a.riquelme.perez@gmail.com.
Jazyk: English; Spanish; Castilian
Zdroj: Gastroenterologia y hepatologia [Gastroenterol Hepatol] 2022 Oct; Vol. 45 (8), pp. 593-604. Date of Electronic Publication: 2022 Jan 22.
DOI: 10.1016/j.gastrohep.2021.12.009
Abstrakt: 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 (I 2 :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.
(Copyright © 2022 Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE