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

Cucinotta, 2020, WHO declares COVID-19 a pandemic, Acta Biomed, 91, 157 Dong, 2020, An interactive web-based dashboard to track COVID-19 in real time, Lancet Infect Dis, 10.1016/S1473-3099(20)30120-1 Wang, 2020, Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China, JAMA, 10.1001/jama.2020.1585 Gu, 2020, COVID-19: gastrointestinal manifestations and potential fecal–oral transmission, Gastroenterology, 10.1053/j.gastro.2020.02.054 Cheung, 2020, Gastrointestinal manifestations of SARS-CoV-2 infection and virus load in fecal samples from the Hong Kong Cohort and systematic review and meta-analysis, Gastroenterology Pan, 2020, Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional multicenter study, Am J Gastroenterol, 10.14309/ajg.0000000000000620 Díaz, 2020, Symptom profiles and risk factors for hospitalization in patients with SARS-CoV-2 and COVID-19: a large cohort from South America, Gastroenterology, 10.1053/j.gastro.2020.05.014 Ling, 2020, Persistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation patients, Chin Med J (Engl), 10.1097/CM9.0000000000000774 Sultan, 2020, AGA Institute rapid review of the gi and liver manifestations of COVID-19 meta-analysis of international data, and recommendations for the consultative management of patients with COVID-19, Gastroenterology, 10.1053/j.gastro.2020.05.001 Wang, 2020, Detection of SARS-CoV-2 in different types of clinical specimens, JAMA, 323, 1843 Liberati, 2009, The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration, BMJ, 339, b2700, 10.1136/bmj.b2700 Lin, 2018, Bias caused by sampling error in meta-analysis with small sample sizes, PLOS ONE, 13, e0204056, 10.1371/journal.pone.0204056 Barendregt, 2013, Meta-analysis of prevalence, J Epidemiol Community Health, 67, 974, 10.1136/jech-2013-203104 Thompson, 2002, How should meta-regression analyses be undertaken and interpreted?, Stat Med, 21, 1559, 10.1002/sim.1187 Core Team, 2013 Nyaga, 2014, Metaprop: a Stata command to perform meta-analysis of binomial data, Arch Public Health, 72, 39, 10.1186/2049-3258-72-39 Huang, 2020, Chronological changes of viral shedding in adult inpatients with COVID-19 in Wuhan, China, Clin Infect Dis, 10.1093/cid/ciaa631 Miri, 2020, Panic of buying toilet papers: a historical memory or a horrible truth? Systematic review of gastrointestinal manifestations of COVID-19, Hepat Mon, 20, e102729, 10.5812/hepatmon.102729 Rodriguez-Morales, 2020, Clinical, laboratory and imaging features of COVID-19: a systematic review and meta-analysis, Travel Med Infect Dis, 101623, 10.1016/j.tmaid.2020.101623 Cao Y, Liu X, Xiong L, Cai K. Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2: a systematic review and meta-analysis. J Med Virol; n/a. Li L-q, Huang T, Wang Y-q, Wang Z-p, Liang Y, Huang T-b, et al. COVID-19 patients’ clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol; n/a. Wan, 2020, Receptor recognition by the novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS coronavirus, J Virol, 94 Liang, 2020, Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus, Gut, 10.1136/gutjnl-2020-320832 Zhou, 2020, Discovery of a novel coronavirus associated with the recent pneumonia outbreak in humans and its potential bat origin, bioRxiv Letko, 2020, Functional assessment of cell entry and receptor usage for SARS-CoV-2 and other lineage B betacoronaviruses, Nat Microbiol, 5, 562, 10.1038/s41564-020-0688-y Hashimoto, 2012, ACE2 links amino acid malnutrition to microbial ecology and intestinal inflammation, Nature, 487, 477, 10.1038/nature11228 Chen, 2020, The presence of SARS-CoV-2 RNA in feces of COVID-19 patients, J Med Virol Lo, 2020, Evaluation of SARS-CoV-2 RNA shedding in clinical specimens and clinical characteristics of 10 patients with COVID-19 in Macau, Int J Biol Sci, 16, 1698, 10.7150/ijbs.45357 Chen, 2020, SARS-CoV-2-positive sputum and feces after conversion of pharyngeal samples in patients with COVID-19, Ann Intern Med, 10.7326/M20-0991 Wolfel, 2020, Virological assessment of hospitalized patients with COVID-2019, Nature, 10.1038/s41586-020-2196-x Nicastri, 2020, Coronavirus disease (COVID-19) in a paucisymptomatic patient: epidemiological and clinical challenge in settings with limited community transmission, Italy February 2020, Euro Surveill, 25 Zhang, 2020, Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes, Emerg Microb Infect, 9, 386, 10.1080/22221751.2020.1729071 Wu, 2020, Prolonged presence of SARS-CoV-2 viral RNA in faecal samples, Lancet Gastroenterol Hepatol, 10.1016/S2468-1253(20)30083-2 Lin, 2020, Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection, Gut, 10.1136/gutjnl-2020-321013 Lodder, 2020, SARS-CoV-2 in wastewater: potential health risk, but also data source, Lancet Gastroenterol Hepatol, 10.1016/S2468-1253(20)30087-X La Rosa, 2020, First detection of SARS-CoV-2 in untreated wastewaters in Italy, Sci Total Environ, 736, 139652, 10.1016/j.scitotenv.2020.139652 Ahmed, 2020, First confirmed detection of SARS-CoV-2 in untreated wastewater in Australia: a proof of concept for the wastewater surveillance of COVID-19 in the community, Sci Total Environ, 728, 138764, 10.1016/j.scitotenv.2020.138764 Ampuero, 2020, SARS-CoV-2 detection in sewage in Santiago Chile – preliminary results, medRxiv Xiao, 2020, Infectious SARS-CoV-2 in feces of patient with severe COVID-19, Emerg Infect Dis J, 26 Lamers, 2020, SARS-CoV-2 productively infects human gut enterocytes, Science, 10.1126/science.abc1669 Zhou, 2020, Infection of bat and human intestinal organoids by SARS-CoV-2, Nat Med, 26, 1077, 10.1038/s41591-020-0912-6 Randazzo, 2020, SARS-CoV-2 RNA in wastewater anticipated COVID-19 occurrence in a low prevalence area, Water Res, 181, 115942, 10.1016/j.watres.2020.115942 Daughton, 2020, Wastewater surveillance for population-wide Covid-19: The present and future, Sci Total Environ, 736, 139631, 10.1016/j.scitotenv.2020.139631 Woloshin, 2020, False negative tests for SARS-CoV-2 infection – challenges and implications, N Engl J Med, 383, e38, 10.1056/NEJMp2015897 Kortela, 2021, Real-life clinical sensitivity of SARS-CoV-2 RT-PCR test in symptomatic patients, PLOS ONE, 16, e0251661, 10.1371/journal.pone.0251661 Zhao, 2020, expression profiling of ACE2, the putative receptor of Wuhan 2019-nCov, bioRxiv Takahashi, 2020, Sex differences in immune responses to SARS-CoV-2 that underlie disease outcomes, medRxiv: the preprint server for health sciences Abdullah, 2021, The value of anal swab RT-PCR for COVID-19 diagnosis in adult Indonesian patients, BMJ Open Gastroenterol, 8 Chen, 2020, Detectable 2019-nCoV viral RNA in blood is a strong indicator for the further clinical severity, Emerg Microbes Infect, 9, 469, 10.1080/22221751.2020.1732837 Dreher, 2020, The characteristics of 50 hospitalized COVID-19 patients with and without ARDS, Dtsch Arztebl Int, 117, 271 Han, 2020, Digestive symptoms in COVID-19 patients with mild disease severity: clinical presentation stool viral RNA testing, and outcomes, Am J Gastroenterol, 115, 916, 10.14309/ajg.0000000000000664 Jiang, 2020, Asymptomatic SARS-CoV-2 infected case with viral detection positive in stool but negative in nasopharyngeal samples lasts for 42 days, J Med Virol, 10.1002/jmv.25941 Jiehao, 2020, A case series of children with 2019 novel coronavirus infection: clinical and epidemiological features, Clin Infect Dis, 10.1093/cid/ciaa198 Kujawski, 2020, First 12 patients with coronavirus disease 2019 (COVID-19) in the United States, medRxiv Li, 2020, Transmission routes analysis of SARS-CoV-2: a systematic review and case report, Front Cell Dev Biol, 8, 618, 10.3389/fcell.2020.00618 Lescure, 2020, Clinical and virological data of the first cases of COVID-19 in Europe: a case series, Lancet Infectious Dis, 20, 697, 10.1016/S1473-3099(20)30200-0 Pan, 2020, Viral load of SARS-CoV-2 in clinical samples, Lancet Infect Dis, 20, 411, 10.1016/S1473-3099(20)30113-4 Wei, 2020, Diarrhea is associated with prolonged symptoms and viral carriage in corona virus disease 2019, Clin Gastroenterol Hepatol, 18, 1753, 10.1016/j.cgh.2020.04.030 Wolf, 2020, Clinical and epidemiological features of a family cluster of symptomatic and asymptomatic severe acute respiratory syndrome coronavirus 2 infection, J Pediatr Infect Dis Soc, 10.1093/jpids/piaa060 Xiao, 2020, Evidence for gastrointestinal infection of SARS-CoV-2, Gastroenterology, 10.1053/j.gastro.2020.02.055 Xing, 2020, Prolonged viral shedding in feces of pediatric patients with coronavirus disease 2019, J Microbiol Immunol Infect, 53, 473, 10.1016/j.jmii.2020.03.021 Xiong, 2020, Comparative study of the clinical characteristics and epidemiological trend of 244 COVID-19 infected children with or without GI symptoms, Gut, 10.1136/gutjnl-2020-321486 Xu, 2020, Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding, Nat Med, 26, 502, 10.1038/s41591-020-0817-4 Yang, 2020, [Three cases of novel coronavirus pneumonia with viral nucleic acids still positive in stool after throat swab detection turned negative], Chin J Dig, 40 Young, 2020, Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore, JAMA, 323, 1488, 10.1001/jama.2020.3204 Zautner AE, Bauswein M, Dörschug A, Blaschk S, Lugert R, Ellenrieder V, et al. High proportion of SARS-CoV-2 RNA persistence in IgG-positive patients with COVID-19. Available at SSRN: https://ssrn.com/abstract=3605269 2020. Zhang, 2020, Fecal specimen diagnosis 2019 novel coronavirus-infected pneumonia, J Med Virol, 92, 680, 10.1002/jmv.25742 Zeng, 2020, Neonatal early-onset infection with SARS-CoV-2 in 33 neonates born to mothers with COVID-19 in Wuhan, China, JAMA Pediatrics, 174, 722, 10.1001/jamapediatrics.2020.0878 Zheng, 2020, Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China January–March 2020: retrospective cohort study, BMJ, 369, m1443, 10.1136/bmj.m1443