Luis Antonio Díaz, Tamara García-Salum, Eduardo Fuentes-López, Diego Reyes, Javier Ortiz, Javier Chahuan, Jorge Levican, Leonardo I Almonacid, Gonzalo H Valenzuela, Eileen Serrano, Sigall Budnik, Vicente Gandara, Andrea Gallardo, María Francisca Seydewitz, Marcela Ferrés, Colomba Cofré, Manuel Álvarez, Carolina Pavez, Roberto Candia, Hugo Monrroy, Alberto Espino, Gabriel Rada, Luis Ortiz, Sebastián Valderrama, Erick Salinas, Adriana Toro, Marcos Ortega, Margarita Pizarro, Rafael A Medina, Arnoldo Riquelme
Journal: Gastroenterologia y hepatologia 2022;45(8):593-604
PMID: 35077722
OBJECTIVES
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 (I: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.
Copyright © 2022 Elsevier España, S.L.U. All rights reserved.
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