Centre for Epidemiology and Public Health, Federal University of Alagoas, Arapiraca.
Department of Medicine, Division of Pediatrics.
J Pediatr Gastroenterol Nutr. 2020 Aug;71(2):150-152. doi: 10.1097/MPG.0000000000002798.
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.
本研究旨在探讨新型冠状病毒疾病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 项报告了 36 名儿童数据的研究。与呼吸道样本相比,更多的儿童在症状出现后 14 天粪便中有病毒脱落(风险比=3.2,95%置信区间 1.2-8.9,I2=51%)。粪便样本中病毒 RNA 的脱落时间较长,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%),而呼吸道样本的脱落时间较短。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 SARS-CoV-2 并不能确认其传染性,但新型冠状病毒疾病在全球范围内的高传播速度表明,其他传播途径也很可能存在。
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