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Published on: July 22, 2012
Gastrointestinal viral shedding in children with SARS-CoV-2: a systematic review and meta-analysis
Sepideh Benvari1, Shima Mahmoudi2, Mohsen Mohammadi3
1Department of Microbiology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
Insights
In children with COVID-19, gastrointestinal shedding of SARS-CoV-2 RNA is common, with 86% prevalence. This shedding can persist for over 70 days, even after respiratory samples test negative.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Gastroenterology
Background:
- Coronavirus disease 2019 (COVID-19) presents differently in children, potentially with more gastrointestinal symptoms.
- The viral shedding pattern in pediatric gastrointestinal samples requires further investigation.
Purpose of the Study:
- To systematically review and meta-analyze the viral shedding pattern in gastrointestinal specimens of children diagnosed with COVID-19.
Main Methods:
- A comprehensive search of PubMed, Web of Science, and Scopus was conducted up to October 2021.
- Included studies focused on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding in pediatric gastrointestinal specimens (rectal swabs, stool).
- Ten studies were included in the meta-analysis, excluding case reports and duplicated data.
Main Results:
- The pooled prevalence of SARS-CoV-2 RNA in the gastrointestinal tract of children with COVID-19 was 86% (95% CI: 73%-96%).
- Persistent gastrointestinal shedding was observed in 72% of cases even after respiratory samples turned negative.
- Positive SARS-CoV-2 RNA results in gastrointestinal specimens were detected for over 70 days post-symptom onset.
Conclusions:
- Gastrointestinal shedding of SARS-CoV-2 is prevalent in children and can be long-lasting.
- Further research is needed to understand the role of gastrointestinal shedding in pediatric COVID-19 transmission.
Background:
Coronavirus disease 2019 (COVID-19) has different manifestations in pediatric cases. It is assumed that they might present more gastrointestinal symptoms with a different viral shedding pattern in gastrointestinal samples. In this systematic review and meta-analysis, we aimed to evaluate the viral shedding pattern in gastrointestinal specimens of children with COVID-19.
Methods:
We searched all published studies in English language in PubMed, Web of Science, and Scopus, up to date as of October 2021. Our search included the term "severe acute respiratory syndrome coronavirus 2, COVID-19, SARS-CoV-2, novel coronavirus, or coronavirus; and shed, excrete, secret, or carriage; and stool or rectal; and children or pediatrics". We included studies evaluating SARS-CoV-2 shedding in gastrointestinal specimens, including rectal swabs and stool samples of children with COVID-19 infection. We excluded duplicated data, case reports, and studies without original data.
Results:
Twelve studies met the eligibility criteria for the qualitative synthesis, 10 of which were included in the meta-analysis. The pooled prevalence of gastrointestinal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in children with COVID-19 was 86% (95% confidence interval 73%-96%, I2 = 62.28%). After respiratory specimen had become negative, 72% (43/60) had persistent shedding in gastrointestinal specimens. The gastrointestinal RNA had a positive test result for more than 70 days after symptoms onset.
Conclusions:
Gastrointestinal shedding of SARS-CoV-2 might occur in a substantial portion of children and might persist long after negative respiratory testing. Further research is recommended to find the role of SARS-CoV-2 gastrointestinal shedding in transmission in children.
