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