An infant with a mild SARS-CoV-2 infection detected only by anal swabs: a case report

Li, Juan; Feng, Jing; Liu, Tianhu; Xu, Feng-cheng; Song, Guoqiang

doi:10.1016/j.bjid.2020.04.009

Cited by 18 publications

(13 citation statements)

References 7 publications

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“…Detectability of SARS‐CoV‐2 RNA depends on the type of specimen tested during different stages of the disease (eg respiratory or faecal sample). In most studies in which serial measurements took place, it was reported that viral RNA was more likely to be detected in respiratory tract samples during an early stage of the disease, whereas GI specimens were more likely to be positive later on during the disease 12‐14,22,29‐37 …”

Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: SARS‐CoV‐2 stool testing and the potential for faecal‐oral transmission

Doorn

Meijer

Frampton

et al. 2020

Aliment Pharmacol Ther

128

107

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Summary Background Since the start of the COVID‐19 pandemic, there have been many scientific reports regarding gastrointestinal manifestations. Several reports indicate the possibility of viral shedding via faeces and the possibility of faecal‐oral transmission. Aims To critically assess the clinical relevance of testing stool samples and anal swabs and provide an overview of the potential faecal‐oral transmission of SARS‐CoV‐2. Methods A systematic literature search with MeSH terms was performed, scrutinising the Embase database, Google scholar, MEDLINE database through PubMed and The Cochrane Library, including articles from December 2019 until July 7 2020. Data were subsequently analysed with descriptive statistics. Results Ninety‐five studies were included in the qualitative analysis. 934/2149 (43%) patients tested positive for SARS‐CoV‐2 in stool samples or anal swabs, with positive test results up to 70 days after symptom onset. A meta‐analysis executed with studies of at least 10 patients revealed a pooled positive proportion of 51.8% (95% CI 43.8 ‐ 59.7%). Positive faecal samples of 282/443 patients (64%) remained positive for SARS‐CoV‐2 for a mean of 12.5 days, up to 33 days maximum, after respiratory samples became negative for SARS‐CoV‐2. Viable SARS‐CoV‐2 was found in 6/17 (35%) patients in whom this was specifically investigated. Conclusions Viral shedding of SARS‐CoV‐2 in stool samples occurs in a substantial proportion of patients, making faecal‐oral transmission plausible. Furthermore, detection in stool samples or anal swabs can persist long after negative respiratory testing. Therefore, stool sample or anal swab testing should be (re)considered in relation to decisions for isolating or discharging a patient.

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Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: SARS‐CoV‐2 stool testing and the potential for faecal‐oral transmission

Doorn

Meijer

Frampton

et al. 2020

Aliment Pharmacol Ther

128

107

View full text Add to dashboard Cite

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“…Of the included studies there were 169 case studies/series, 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 63 , 65 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 82 , 83 , 84 , 85 , 86...…”

Section: Resultsunclassified

SARS-CoV-2 routes of transmission and recommendations for preventing acquisition: joint British Infection Association (BIA), Healthcare Infection Society (HIS), Infection Prevention Society (IPS) and Royal College of Pathologists (RCPath) guidance

Bak

Mugglestone

Ratnaraja

et al. 2021

Journal of Hospital Infection

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…The longest interval between the respiratory nucleic acid becoming negative and a positive fecal nucleic acid test was more than 19 days. However, in a study of three neonates, 23 respiratory tract and fecal nucleic acid tests were positive 2 and 4 days after birth, respectively, and the fecal and respiratory tract specimens were negative on the 6th day.An infant with a mild SARS-CoV-2 infection detected only by anal swabs,Throat swabs were persistently negative throughout the hospital stay 51 .…”

Section: Fecal Testing For Viral Nucleic Acidmentioning

confidence: 91%

Gastrointestinal symptoms and fecal nucleic acid testing of children with coronavirus disease 2019: a systematic review and meta-analysis

Wang

Cui

Tang

2020

Preprint

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Objective: To understand the clinical manifestations and incidence of gastrointestinal symptoms of Coronavirus disease (COVID-19) in children and discuss the importance of fecal nucleic acid testing.Methods: Retrospective analysis of studies of gastrointestinal symptoms and fecal nucleic acid detection in pediatric COVID-19 since the outbreak of COVID-19, as well as prospective clinical studies and case reports to understand the clinical characteristics of gastrointestinal symptoms and feces in children. Nucleic acid detection results were also analyzed.Results: 1. The clinical manifestations of gastrointestinal symptoms in children with COVID-19 are mostly vomiting and diarrhea, with a total incidence rate of 21.1% (95%Cl=0.14-0.28).2.When analyzing by country (studies from China versus studies from other countries), the pooled prevalence of gastrointestinal symptoms in studies from countries other than China was much lower at 18.2% (95% CI0.05 to 0.31). This is in comparison to studies from China where the prevalence was higher: 23.3% (95% CI 0.153 to 0.310) .3.In Wuhan patients, the pooled prevalence was much higher at 41.2% (95 % CI 0.147 to 0.678) as compared to areas outside Wuhan，China：15.1%(95 % CI 0.075 to 0.227).4.Fecal nucleic acid detection is as accurate as respiratory specimen nucleic acid detection. The positive rate of fecal nucleic acid testing in COVID-19 patients was 92.5% (25/27). In patients where nucleic acid tests of respiratory tract specimens produced negative results, a positive fecal nucleic acid test result was present in 83.3% (20/24); one week after the respiratory tract specimen was nucleic acid-negative, 54.1% (13/24) were fecal nucleic acid-positive; two weeks after the respiratory tract nucleic acid negative test, 37.5% (9/24) were fecal nucleic acid-positive. The longest interval between a negative respiratory system result and positive fecal specimen result exceeded 19 days.Conclusions and Relevance: Gastrointestinal symptoms in pediatric COVID-19 are relatively common. Attention should be paid to the detection of fecal nucleic acids in children. Fecal nucleic acid-negative status should be considered as one of the desegregation standards.

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An infant with a mild SARS-CoV-2 infection detected only by anal swabs: a case report

Cited by 18 publications

References 7 publications

Systematic review with meta‐analysis: SARS‐CoV‐2 stool testing and the potential for faecal‐oral transmission

Systematic review with meta‐analysis: SARS‐CoV‐2 stool testing and the potential for faecal‐oral transmission

SARS-CoV-2 routes of transmission and recommendations for preventing acquisition: joint British Infection Association (BIA), Healthcare Infection Society (HIS), Infection Prevention Society (IPS) and Royal College of Pathologists (RCPath) guidance

Gastrointestinal symptoms and fecal nucleic acid testing of children with coronavirus disease 2019: a systematic review and meta-analysis

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