%0 Journal Article
%T High prevalence of SARS-CoV-2 detection and prolonged viral shedding in stools: A systematic review and cohort study.
%A Díaz LA
%A García-Salum T
%A Fuentes-López E
%A Reyes D
%A Ortiz J
%A Chahuan J
%A Levican J
%A Almonacid LI
%A Valenzuela GH
%A Serrano E
%A Budnik S
%A Gandara V
%A Gallardo A
%A Seydewitz MF
%A Ferrés M
%A Cofré C
%A Álvarez M
%A Pavez C
%A Candia R
%A Monrroy H
%A Espino A
%A Rada G
%A Ortiz L
%A Valderrama S
%A Salinas E
%A Toro A
%A Ortega M
%A Pizarro M
%A Medina RA
%A Riquelme A
%J Gastroenterol Hepatol
%V 45
%N 8
%D Oct 2022
%M 35077722
%F 5.867
%R 10.1016/j.gastrohep.2021.12.009
%X 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.