Roshandel Mohammad Reza, Nateqi Masoud, Lak Ramin, Aavani Pooya, Sari Motlagh Reza, F Shariat Shahrokh, Aghaei Badr Tannaz, Sfakianos John, Kaplan Steven A, Tewari Ashutosh K
Urology Department of Icahn School of Medicine, Mount Sinai Hospitals, NY, USA.
Center for Biotechnology and Genomics, Texas Tech University, Lubbock, TX, USA.
Cell Mol Biol (Noisy-le-grand). 2020 Sep 30;66(6):148-156.
Investigating the infectivity of body fluid can be useful for preventative measures in the community and ensuring safety in the operating rooms and on the laboratory practices. We performed a literature search of clinical trials, cohorts, and case series using PubMed/MEDLINE, Google Scholar, and Cochrane library, and downloadable database of CDC. We excluded case reports and searched all-language articles for review and repeated until the final drafting. The search protocol was registered in the PROSPERO database. Thirty studies with urinary sampling for viral shedding were included. A total number of 1,271 patients were enrolled initially, among which 569 patients had undergone urinary testing. Nine studies observed urinary viral shedding in urine from 41 patients. The total incidence of urinary SARS-CoV-2 shedding was 8%, compared to 21.3% and 39.5 % for blood and stool, respectively. The summarized risk ratio (RR) estimates for urine positive rates compared to the pharyngeal rate was 0.08. The pertaining RR urine compared to blood and stool positive rates were 0.20 and 0.33, respectively. Our review concludes that not only the SARS-CoV-2 can be excreted in the urine in eight percent of patients but also its incidence may have associations with the severity of the systemic disease, ICU admission, and fatality rates. Moreover, the findings in our review suggest that a larger population size may reveal more positive urinary cases possibly by minimizing biases.
研究体液的传染性有助于社区采取预防措施，并确保手术室和实验室操作的安全。我们使用PubMed/MEDLINE、谷歌学术搜索和Cochrane图书馆以及美国疾病控制与预防中心的可下载数据库，对临床试验、队列研究和病例系列进行了文献检索。我们排除了病例报告，并搜索了所有语言的文章进行综述，重复操作直至完成最终起草。检索方案已在PROSPERO数据库中注册。纳入了30项关于尿液采样检测病毒脱落的研究。最初共纳入1271例患者，其中569例患者接受了尿液检测。9项研究在41例患者的尿液中观察到病毒脱落。尿液中SARS-CoV-2脱落的总发生率为8%，而血液和粪便中的发生率分别为21.3%和39.5%。尿液阳性率与咽拭子阳性率相比的汇总风险比（RR）估计值为0.08。尿液与血液和粪便阳性率相比的相关RR分别为0.20和0.33。我们的综述得出结论，不仅8%的患者尿液中可排出SARS-CoV-2，而且其发生率可能与全身疾病的严重程度、入住重症监护病房情况及死亡率有关。此外，我们综述中的研究结果表明，更大规模的人群研究可能通过尽量减少偏倚揭示更多尿液阳性病例。
