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儿科患者中 SARS-CoV-2 的粪便长时间排出:定量证据综合。

Prolonged Fecal Shedding of SARS-CoV-2 in Pediatric Patients: A Quantitative Evidence Synthesis.

机构信息

Centre for Epidemiology and Public Health, Federal University of Alagoas, Arapiraca.

Department of Medicine, Division of Pediatrics.

出版信息

J Pediatr Gastroenterol Nutr. 2020 Aug;71(2):150-152. doi: 10.1097/MPG.0000000000002798.


DOI:10.1097/MPG.0000000000002798
PMID:32452978
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7268855/
Abstract

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.

摘要

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。

相似文献

[1]
Prolonged Fecal Shedding of SARS-CoV-2 in Pediatric Patients: A Quantitative Evidence Synthesis.

J Pediatr Gastroenterol Nutr. 2020-8

[2]
Duration of Respiratory and Gastrointestinal Viral Shedding in Children With SARS-CoV-2: A Systematic Review and Synthesis of Data.

Pediatr Infect Dis J. 2020-9

[3]
Prolonged viral shedding in feces of pediatric patients with coronavirus disease 2019.

J Microbiol Immunol Infect. 2020-3-28

[4]
Prevalence of Gastrointestinal Symptoms and Fecal Viral Shedding in Patients With Coronavirus Disease 2019: A Systematic Review and Meta-analysis.

JAMA Netw Open. 2020-6-1

[5]
Prevalence and Persistent Shedding of Fecal SARS-CoV-2 RNA in Patients With COVID-19 Infection: A Systematic Review and Meta-analysis.

Clin Transl Gastroenterol. 2021-4-9

[6]
Evaluation of SARS-CoV-2 viral RNA in fecal samples.

Virol J. 2020-6-30

[7]
Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From a Hong Kong Cohort: Systematic Review and Meta-analysis.

Gastroenterology. 2020-7

[8]
The presence of SARS-CoV-2 RNA in the feces of COVID-19 patients.

J Med Virol. 2020-4-25

[9]
Dynamic Viral Severe Acute Respiratory Syndrome Coronavirus 2 RNA Shedding in Children: Preliminary Data and Clinical Consideration from a Italian Regional Center.

J Pediatric Infect Dis Soc. 2020-7-13

[10]
Fecal viral shedding in COVID-19 patients: Clinical significance, viral load dynamics and survival analysis.

Virus Res. 2020-8-28

引用本文的文献

[1]
Fecal shedding of SARS-CoV-2 in infants born to SARS-CoV-2 positive mothers: a pilot study.

PeerJ. 2024

[2]
SARS-CoV-2 excretion kinetics in nasopharyngeal and stool samples from the pediatric population.

Front Med (Lausanne). 2023-10-30

[3]
An alternative method for monitoring and interpreting influenza A in communities using wastewater surveillance.

Front Public Health. 2023

[4]
Long term detection and quantification of SARS-CoV-2 RNA in wastewater in Bahrain.

J Hazard Mater Adv. 2022-8

[5]
Infection, Dysbiosis and Inflammation Interplay in the COVID Era in Children.

Int J Mol Sci. 2023-6-29

[6]
Respiratory Care in Children with COVID-19.

J Pediatr Intensive Care. 2021-2-11

[7]
Wastewater to clinical case (WC) ratio of COVID-19 identifies insufficient clinical testing, onset of new variants of concern and population immunity in urban communities.

Sci Total Environ. 2022-12-20

[8]
COVID-19 and Pediatric Gastroenterology.

Pediatr Clin North Am. 2021-12

[9]
COVID-19 in children and the importance of COVID-19 vaccination.

World J Pediatr. 2021-10

[10]
Transcriptome Analysis of Peripheral Blood Mononuclear Cells Reveals Distinct Immune Response in Asymptomatic and Re-Detectable Positive COVID-19 Patients.

Front Immunol. 2021

本文引用的文献

[1]
Factors associated with mortality in patients with COVID-19. A quantitative evidence synthesis of clinical and laboratory data.

Eur J Intern Med. 2020-6

[2]
Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study.

BMJ. 2020-4-21

[3]
Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children.

Pediatr Infect Dis J. 2020-5

[4]
Epidemiologic and clinical characteristics of 10 children with coronavirus disease 2019 in Changsha, China.

J Clin Virol. 2020-4-10

[5]
Digestive Symptoms in COVID-19 Patients With Mild Disease Severity: Clinical Presentation, Stool Viral RNA Testing, and Outcomes.

Am J Gastroenterol. 2020-6

[6]
Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding.

Nat Med. 2020-3-13

[7]
Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From a Hong Kong Cohort: Systematic Review and Meta-analysis.

Gastroenterology. 2020-7

[8]
Do children need a longer time to shed SARS-CoV-2 in stool than adults?

J Microbiol Immunol Infect. 2020-3-19

[9]
COVID-19 in children: the link in the transmission chain.

Lancet Infect Dis. 2020-6

[10]
Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.

Lancet. 2020-3-11

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