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Published on: September 10, 2021
Prolonged viral shedding in feces of pediatric patients with coronavirus disease 2019
Yu-Han Xing1, Wei Ni2, Qin Wu2
1Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Insights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA persisted in the stools of pediatric patients for over four weeks, longer than in the respiratory tract. This suggests potential fecal-oral transmission routes for COVID-19 in children.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2.
- Understanding viral shedding dynamics is crucial for infection control.
Purpose of the Study:
- To investigate the dynamic changes of SARS-CoV-2 RNA in respiratory and fecal specimens of children with COVID-19.
- To compare viral RNA clearance timelines between different sample types.
Main Methods:
- Retrospective analysis of three pediatric COVID-19 cases.
- Monitoring of SARS-CoV-2 RNA in throat swabs and fecal specimens.
- Data collection included epidemiological, clinical, laboratory, and radiological characteristics.
Main Results:
- SARS-CoV-2 RNA clearance from the respiratory tract occurred within two weeks post-fever.
- Viral RNA remained detectable in pediatric stools for over four weeks.
- Two children showed undetectable fecal SARS-CoV-2 20 days after negative respiratory swabs, while one child had an 8-day lag.
Conclusions:
- SARS-CoV-2 may persist longer in the pediatric gastrointestinal tract than the respiratory system.
- Persistent fecal shedding raises concerns about potential transmission via contaminated fomites.
- Preventive measures are essential to curb transmission among children, especially after school reopenings.
Objective:
To determine the dynamic changes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in respiratory and fecal specimens in children with coronavirus disease 2019 (COVID-19).
Methods:
From January 17, 2020 to February 23, 2020, three paediatric cases of COVID-19 were reported in Qingdao, Shandong Province, China. Epidemiological, clinical, laboratory, and radiological characteristics and treatment data were collected. Patients were followed up to March 10, 2020, and dynamic profiles of nucleic acid testing results in throat swabs and fecal specimens were closely monitored.
Results:
Clearance of SARS-CoV-2 in respiratory tract occurred within two weeks after abatement of fever, whereas viral RNA remained detectable in stools of pediatric patients for longer than 4 weeks. Two children had fecal SARS-CoV-2 undetectable 20 days after throat swabs showing negative, while that of another child lagged behind for 8 days.
Conclusions:
SARS-CoV-2 may exist in children's gastrointestinal tract for a longer time than respiratory system. Persistent shedding of SARS-CoV-2 in stools of infected children raises the possibility that the virus might be transmitted through contaminated fomites. Massive efforts should be made at all levels to prevent spreading of the infection among children after reopening of kindergartens and schools.
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