Abstract：
OBJECTIVE: To: 1. Describe the frequency of viral RNA detection in stools in a cohort of patients infected with SARS-CoV-2, and 2. Perform a systematic review to assess the clearance time in stools of SARS-CoV-2.
METHODS: We conducted a prospective cohort study in two centers between March and May 2020. We included SARS-CoV-2 infected patients of any age and severity. We collected seriated nasopharyngeal swabs and stool samples to detect SARS-CoV-2. After, we performed a systematic review of the prevalence and clearance of SARS-CoV-2 in stools (PROSPERO-ID: CRD42020192490). We estimated prevalence using a random-effects model. We assessed clearance time by using Kaplan-Meier curves.
RESULTS: We included 32 patients; mean age was 43.7±17.7 years, 43.8% were female, and 40.6% reported gastrointestinal symptoms. Twenty-five percent (8/32) of patients had detectable viral RNA in stools. The median clearance time in stools of the cohort was 11[10-15] days. Systematic review included 30 studies (1392 patients) with stool samples. Six studies were performed in children and 55% were male. The pooled prevalence of viral detection in stools was 34.6% (twenty-four studies, 1393 patients; 95%CI:25.4-45.1); heterogeneity was high (I2:91.2%, Q:208.6; p≤0.001). A meta-regression demonstrates an association between female-gender and lower presence in stools (p=0.004). The median clearance time in stools was 22 days (nineteen studies, 140 patients; 95%CI:19-25). After 34 days, 19.9% (95%CI:11.3-29.7) of patients have a persistent detection in stools.
CONCLUSIONS: Detection of SARS-CoV-2 in stools is a frequent finding. The clearance of SARS-CoV-2 in stools is prolonged and it takes longer than nasopharyngeal secretions.
METHODS: We conducted a prospective cohort study in two centers between March and May 2020. We included SARS-CoV-2 infected patients of any age and severity. We collected seriated nasopharyngeal swabs and stool samples to detect SARS-CoV-2. After, we performed a systematic review of the prevalence and clearance of SARS-CoV-2 in stools (PROSPERO-ID: CRD42020192490). We estimated prevalence using a random-effects model. We assessed clearance time by using Kaplan-Meier curves.
RESULTS: We included 32 patients; mean age was 43.7±17.7 years, 43.8% were female, and 40.6% reported gastrointestinal symptoms. Twenty-five percent (8/32) of patients had detectable viral RNA in stools. The median clearance time in stools of the cohort was 11[10-15] days. Systematic review included 30 studies (1392 patients) with stool samples. Six studies were performed in children and 55% were male. The pooled prevalence of viral detection in stools was 34.6% (twenty-four studies, 1393 patients; 95%CI:25.4-45.1); heterogeneity was high (I2:91.2%, Q:208.6; p≤0.001). A meta-regression demonstrates an association between female-gender and lower presence in stools (p=0.004). The median clearance time in stools was 22 days (nineteen studies, 140 patients; 95%CI:19-25). After 34 days, 19.9% (95%CI:11.3-29.7) of patients have a persistent detection in stools.
CONCLUSIONS: Detection of SARS-CoV-2 in stools is a frequent finding. The clearance of SARS-CoV-2 in stools is prolonged and it takes longer than nasopharyngeal secretions.
摘要：
目的:目的:1.描述感染SARS-CoV-2和2的患者队列中粪便中病毒RNA检测的频率。进行系统评价以评估SARS-CoV-2粪便的清除时间。
方法：我们于2020年3月至5月在两个中心进行了一项前瞻性队列研究。我们纳入了任何年龄和严重程度的SARS-CoV-2感染患者。我们收集了连续的鼻咽拭子和粪便样本以检测SARS-CoV-2。之后，我们对粪便中SARS-CoV-2的患病率和清除率进行了系统评价(PROSPERO-ID:CRD42020192490).我们使用随机效应模型估计患病率。我们使用Kaplan-Meier曲线评估清除时间。
结果：我们包括32例患者；平均年龄为43.7±17.7岁，43.8%是女性，40.6%报告胃肠道症状。25%(8/32)的患者在粪便中检测到病毒RNA。队列中粪便的中位清除时间为11[10-15]天。系统评价包括30项研究（1392例患者）的粪便样本。六项研究在儿童中进行，55%为男性。粪便中病毒检测的汇总患病率为34.6%(24项研究，1393例；95CI：25.4-45.1）；异质性高（I2：91.2％，Q:208.6;p≤0.001)。荟萃回归表明女性与粪便含量较低之间存在关联（p=0.004）。粪便的中位清除时间为22天(19项研究，140名患者；95CI：19-25）。34天后,19.9%(95CI:11.3-29.7)的患者有持续的粪便检测。
结论：粪便中SARS-CoV-2的检测是一个常见的发现。粪便中SARS-CoV-2的清除时间延长，并且比鼻咽分泌物需要更长的时间。
方法：我们于2020年3月至5月在两个中心进行了一项前瞻性队列研究。我们纳入了任何年龄和严重程度的SARS-CoV-2感染患者。我们收集了连续的鼻咽拭子和粪便样本以检测SARS-CoV-2。之后，我们对粪便中SARS-CoV-2的患病率和清除率进行了系统评价(PROSPERO-ID:CRD42020192490).我们使用随机效应模型估计患病率。我们使用Kaplan-Meier曲线评估清除时间。
结果：我们包括32例患者；平均年龄为43.7±17.7岁，43.8%是女性，40.6%报告胃肠道症状。25%(8/32)的患者在粪便中检测到病毒RNA。队列中粪便的中位清除时间为11[10-15]天。系统评价包括30项研究（1392例患者）的粪便样本。六项研究在儿童中进行，55%为男性。粪便中病毒检测的汇总患病率为34.6%(24项研究，1393例；95CI：25.4-45.1）；异质性高（I2：91.2％，Q:208.6;p≤0.001)。荟萃回归表明女性与粪便含量较低之间存在关联（p=0.004）。粪便的中位清除时间为22天(19项研究，140名患者；95CI：19-25）。34天后,19.9%(95CI:11.3-29.7)的患者有持续的粪便检测。
结论：粪便中SARS-CoV-2的检测是一个常见的发现。粪便中SARS-CoV-2的清除时间延长，并且比鼻咽分泌物需要更长的时间。
