Prolonged Fecal Shedding of SARS-CoV-2 in Pediatric Patients: A Quantitative Evidence Synthesis
Prolonged Fecal Shedding of SARS-CoV-2 in Pediatric Patients: A Quantitative Evidence Synthesis
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DOI：
10.1097/mpg.0000000000002798
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发表时间：
2020-08-01
影响因子：
2.9
通讯作者：
Martins-Filho, Paulo R.
中科院分区：
文献类型：
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作者：
Santos, Victor S.;Gurgel, Ricardo Q.;Martins-Filho, Paulo R.
该研究的目的是调查新型冠状病毒病19儿童呼吸道和粪便样本中病毒脱落的差异。我们检索了PubMed、SCOPUS、Embase和Web of Science数据库，以确定比较严重急性呼吸综合征冠状病毒2（SARS-CoV-2）RNA粪便和呼吸道脱落模式的儿科研究。使用随机效应模型计算汇总估计值。纳入了4项报告36名儿童数据的研究。与呼吸道样本相比，症状发作14天后粪便中病毒脱落的儿童比例更高（风险比= 3.2，95%置信区间1.2-8.9，I2 = 51%）。与呼吸道样本相比，粪便样本中的病毒RNA脱落时间更长，平均差异约为9天（平均差异= 8.6，95%置信区间1.7-15.4，I2=77%）。SARS-CoV-2脱落似乎在粪便中存在的时间比在儿童呼吸道中存在的时间长。虽然粪便中存在的SARS-CoV-2不能证实其传播性，但新型冠状病毒疾病在全球范围内的高度和快速传播表明其他传播途径也是合理的。
The aim of the study was to investigate differences in viral shedding in respiratory and fecal samples from children with novel coronavirus disease 19. We searched PubMed, SCOPUS, Embase, and Web of Science databases to identify pediatric studies comparing the pattern of fecal and respiratory shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA. Summary estimates were calculated using random-effects models. Four studies reporting data from 36 children were included. A higher proportion of children had viral shedding in stools after 14 days of symptoms onset compared to respiratory samples (risk ratio = 3.2, 95% confidence interval 1.2-8.9, I2 = 51%). Viral RNA shedding was longer in fecal samples with a mean difference of approximately 9 days (mean difference = 8.6, 95% confidence interval 1.7-15.4, I2=77%) compared with respiratory samples. SARS-CoV-2 shedding seems to be present in feces for a longer time than in the respiratory tract of children. Although fecal SARS-CoV-2 presence in feces do not confirm its transmissibility, the high and fast spread of the novel coronavirus disease 19 worldwide indicate other transmission routes are also plausible.