COVID-19: fecal shedding in children
COVID-19: Fecal shedding in children. Jefferson T, Heneghan C
Published on June 30, 2020
Transmission Dynamics of COVID-19
||Santos VS, Gurgel RQ, Cuevas LE, Martins-Filho PR. Prolonged fecal shedding of SARS-CoV-2 in pediatric patients. A quantitative evidence synthesis. J Pediatr Gastroenterol Nutr. 2020;10.1097/MPG.0000000000002798. 2020
Fecal shedding in children with COVID-19 occurs on average nine days longer than by the respiratory route
On admission, SARS-CoV-2 RNA was detected respectively in 95% (34/36) and 69% (22/32) of respiratory and fecal samples by RT-PCR. This a lower detection rate than in SARS (86%) but higher than MERS (15%).
Three times as many children had SARS-CoV-2 shedding in stools after 14 days of symptoms onset compared to respiratory samples, RR= 3.2 (95%CI 1.2 to 8.9).
Viral RNA shedding was approximately 9 days in fecal samples (mean difference = 8.6, 95%CI 1.7 to 15.4) compared with respiratory samples.
What did they do?
The study is a systematic review of 4 case series (36 children, 15 boys and 21 girls, aged 56 to 91 months) aimed at investigating differences in viral shedding in respiratory and fecal samples from children with COVID-19. All children had mild symptoms and none died.
The duration of viral shedding in respiratory swabs and stool samples was defined as the number of days from symptoms onset to the day when the last specimen in which SARS-CoV-2 was detected.
The circumstances of selection and settings of the children in the original case series are unclear and the testing is not described in any great detail. The authors of the review are unsure whether the fecally shed viruses were viable and hence infectious.
|Clearly defined setting
||Demographic characteristics described
||Follow-up length was sufficient
||Transmission outcomes assessed
||Main biases are taken into consideration
What else should I consider?
The results of this review are preliminary but potentially very important but need verification and development.
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About the authors