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Gastrointestinal viral shedding in children with SARS‑CoV‑2:a systematic review and meta‑analysis

World Journal of Pediatrics 2022年第9期18卷 582-588页

作者： Sepideh Benvari Shima Mahmoudi Mohsen Mohammadi Department of Microbiology Faculty of MedicineQazvin University of Medical SciencesQazvinIran Pediatric Infectious Disease Research Center Tehran University of Medical SciencesTehranIran Non-Communicable Pediatric Diseases Research Center Health Research InstituteBabol University of Medical SciencesBabolIran

Background Coronavirus disease 2019(COVID-19)has diferent manifestations in pediatric *** is assumed that they might present more gastrointestinal symptoms with a diferent viral shedding pattern in gastrointestinal *** this systematic review and meta-analysis,we aimed to evaluate the viral shedding pattern in gastrointestinal specimens of children with *** We searched all published studies in English language in PubMed,Web of Science,and Scopus,up to date as of October *** 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 *** excluded duplicated data,case reports,and studies without original *** Twelve studies met the eligibility criteria for the qualitative synthesis,10 of which were included in the *** pooled prevalence of gastrointestinal severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)RNA in children with COVID-19 was 86%(95%confdence interval 73%–96%,I 2=62.28%).After respiratory specimen had become negative,72%(43/60)had persistent shedding in gastrointestinal *** gastrointestinal RNA had a positive test result for more than 70 days after symptoms *** Gastrointestinal shedding of SARS-CoV-2 might occur in a substantial portion of children and might persist long after negative respiratory *** research is recommended to fnd the role of SARS-CoV-2 gastrointestinal shedding in transmission in children.

关键词： Coronavirus disease 2019(COVID-19) Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) viral shedding

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Prolonged SARS-CoV-2 viral shedding in Patients with COVID-19 was Associated with Delayed Initiation of Arbidol Treatment and Consulting Doctor Later: A Retrospective Cohort Study

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Current Medical Science 2021年第6期41卷 1096-1104页

作者： Xin-liang HE Ya-ya ZHOU Wei FU Yu-e XUE Meng-yuan LIANG Bo-han YANG Wan-li MA Qiong ZHOU Long CHEN Jian-chu ZHANG Xiao-rong WANG Department of Respiratory and Critical Care Medicine Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China

Objective:To study data about SARS-CoV-2 virus shedding and clarify the risk factors for prolonged virus ***:Data were retrospectively collected from adults hospitalized with laboratory-confirmed coronavirus disease-19(COVID-19)in Wuhan Union *** compared clinical features among patients with prolonged(a positive SARS-CoV-2 RNA on day 23 after illness onset)and short virus shedding and evaluated risk factors associated with prolonged virus shedding by multivariate regression ***:Among 238 patients,the median age was 55.5 years,57.1%were female,92.9%(221/238)were administered with arbidol,58.4%(139/238)were given arbidol in combination with *** median duration of SARS-CoV-2 virus shedding was 23 days(IQR,17.8-30 days)with a longest one of 51 *** patients with prolonged virus shedding had higher value of D-dimer(P=0.002),IL-6(Pshedding less than 23 *** regression analysis revealed that prolonged viral shedding was significantly associated with initiation arbidol≥8 days after symptom onset[OR:2.447,95%CI(1.351-4.431)],≥3 days from onset of symptoms to first medical visitation[OR:1.880,95%CI(1.035-3.416)],illness onset before Jan.31,2020[OR:3.289,95%CI(1.474-7.337)].Arbidol in combination with interferon was also significantly associated with shorter virus shedding[OR:0.363,95%CI(0.191-0.690)].Conclusion:Duration of SARS-CoV-2 virus shedding was *** initiation of arbidol and arbidol in combination with interferon as well as consulting doctor timely after illness onset were helpful for SARS-CoV-2 clearance.

关键词： SARS-CoV-2 viral shedding risk factors antiviral treatment arbidol

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Characteristics of viral shedding in Respiratory Samples and Specific Antibodies Production in 564 COVID-19 Patients

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Current Medical Science 2021年第1期41卷 46-50页

作者： Jing GONG Hui DONG Ding-kun WANG Fu-er LU Zhao-yi HUANG Ke FANG Wen-ya HUANG Fen YUAN Xing CHEN Qing-song XIA Le-yi MA Fan WU Hao SU Min-min GONG Yue-heng TANG Ke-xin NIE Zhi WANG Sheng-hao TU Ming-min ZHANG Jing-bin LI Department of Integrated Traditional Chinese and Western Medicine Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Institute of Integrated Traditional Chinese and Western Medicine Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Clinical Laboratory Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

Positive nucleic acid(NA)results have been found in recovered and discharged COVID-19 patients,but the proportion is *** study was designed to analyze the recurrent positive rate of NA results after consecutively negative results,and the relationship between the specific antibody production and positive NA *** to Strengthening the Reporting of Observational Studies in Epidemiology guidelines,data of inpatients in Sino-French New City Branch of Tongji Hospital between Jan.28 and Mar.6,2020 were collected.A total of 564 COVID-19 patients over 14 years old who received the examinations of NA and antibodies against SARS-CoV-2 were *** of viral shedding and specific antibodies were recorded and *** NA tests in respiratory samples(throat swabs,nasopharyngeal swabs,sputum and flushing fluid in alveoli),the patients with all-negative NA results accounted for 17.20%,those with single-positive results for 46.63%,and those with multiple-positive results for 36.17%***,the recurrent positive NA results after consecutively negative results appeared in 66 patients(11.70%).For multiple-positive patients,median viral shedding duration was 20 days(range:1 to 57 days).Of the 205 patients who received 2 or more antibody tests,141(68.78%)had decreased IgG and IgM *** decreased to normal range in 24 patients,with a median of 44 days from symptom *** shedding duration was not significantly correlated with gender,age,disease severity,changes in pulmonary imaging,and antibody *** is concluded that antibody level and antibody change had no significant correlation with the positive rate of NA tests and the conversion rate after continuous negative NA *** order to reduce the recurrent positive proportion after discharge,3 or more consecutive negative NA test results with test interval more than 24 h every time are suggested for the discharge or release from quarantine.

关键词： COVID-19 viral shedding specific antibodies

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viral shedding in Chinese young adults with mild 2009 H1N： influenza

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Chinese Medical Journal 2011年第10期124卷 1576-1579页

作者： JIA Ning GAO Yan SUO Ji-jiang XIE Li-jun YAN Zhong-qiang XING Yu-bin HE Lei LIU Yun-xi Department of Nosocomial Infection and Disease Control People's Liberation Army General Hospital Beijing 100853. China Department of Police Research People's Liberation Army General Hospital Beijing 100853. China Department of Hepatobiliary Surgery People's Liberation Army General Hospital Beijing 100853. China

Background The duration of viral shedding and the transmission of 2009 H1N1 influenza among individuals, especially among the younger population with mild illness, are not well understood now. The aim of this study was to determine the viral shedding of the young adult patients with mild 2009 H1N1 influenza in *** From September 2009 to January 2010, the clinical data and serial nasopharyngeal swabs of 67 patients with 2009 H1N1 influenza and 37 patients with seasonal influenza aged from 18 years to 35 years were collected. The nasopharyngeal swab samples were detected by real time RT-PCR to determine the viral shedding. All the patients did not receive the antiviral therapy but Chinese medicine for *** Among the patients with H1N1 virus infection, 82.1% （55/67） patients presented with fever symptom, while more patients with high fever （≥39℃） were found in seasonal influenza patients （P〈0.05）. For the H1N1 patients, the median interval between the symptom onset and the undetectable RNA was six days （4-10 days）. But viral shedding was still found in 31.3% patients after 7 days following illness onset. The median interval between disappearance of fever and an undetectable viral RNA level was three days （2-8 days）, and 17.9% patients were found to be viral shedding 6 days later after normalization of body temperature. For the seasonal influenza patients, 94.6% patients were detected out viral RNA within 7 days. The median interval of seasonal influenza between the symptom onset and the undetectable RNA was four days （3-8 days）. The median interval between disappearance of fever and an undetectable viral RNA level was three days （2-6 days）.Conclusion It suggests that 7 days isolation period from the illness onset or 24 hours after the resolution of fever and respiratory symptoms are not long enough to cut off the transmission among Chinese young adults with mild illness

关键词： H1N1 influenza virus infection viral shedding

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Nomogram for Predicting viral shedding Time of SARS-CoV-2 Delta Variant in Patients with COVID-19:A Retrospective Study

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Infectious Diseases & Immunity 2023年第2期3卷 67-74页

作者： Jiejun Zhou Lin Fan Duo Li Mingwei Chen Tian Yang Department of Respiratory and Critical Care Medicine the First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710000China Department of General Surgery the First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710000China.

Background The coronavirus disease 2019(COVID-19)cases continue to rise,and the demand for medical treatment and resources in healthcare systems *** the viral shedding time(VST)of patients with COVID-19 can facilitate clinical decision *** some studies have been conducted on the factors affecting the VST of severe acute respiratory syndrome coronavirus 2(SARS-COV-2),few prediction models are currently *** This retrospective study included the consecutive patients with COVID-19 admitted to Xi’an Chest Hospital in Shaanxi,China,for treatment between December 19,2021 and February 5,*** clinical data of the patients were extracted from their electronic medical *** significant factors affecting the VST,a nomogram was developed to predict the VST of the SARS-CoV-2 Delta variant in patients with *** We included 332 patients in this *** average VST was 21 *** was significantly prolonged in patients with severe clinical symptoms,sore throat,old age,long time from onset to diagnosis,and an abnormal white blood cell ***,we developed a nomogram prediction model using these 5 *** concordance index(C-index)of this nomogram was 0.762,and after internal validation using bootstrapping(1000 resamples),the adjusted C-index was *** area under the nomogram’s receiver operator characteristic curve showed good discriminative ability(0.965).The calibration curve showed high *** VST was prolonged in the group with lower model fitting scores according to the Kaplan-Meier curve(χ2=286,log-rank Pviral transmission,and optimize clinical strategies.

关键词： COVID-19 Delta Prognosis viral shedding Predictive model

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Risk of extended viral shedding of Omicron BA.2 in Shanghai:Implications for vaccination strategy optimization

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Chinese Medical Journal Pulmonary and Critical Care Medicine 2023年第4期1卷 241-248页

作者： Jingwen Huang Lin Huang Jing Xi Yong Li Jianping Zhou Zhiyao Bao Qijian Cheng Qingyun Li Min Zhou Ren Zhao Yanan Li Department of Pulmonary and Critical Care Medicine Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Institute of Respiratory Diseases Shanghai Jiao Tong University School of MedicineShanghai 200025China Shanghai Key Laboratory of Emergency Prevention Diagnosis and Treatment of Respiratory Infectious DiseasesShanghai 200025China Medical Department Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Department of General Surgery Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China

Background:In late March 2022,an outbreak of coronavirus disease 2019(COVID-19)caused by the Omicron BA.2 strain occurred in Shanghai,*** retrospective study aimed to investigate the clinical characteristics,laboratory parameters,and vaccine protectiveness related to this disease in ***:We conducted a single-center retrospective study on 735 patients with COVID-19 hospitalized from March 17 to May 14,*** characteristics were analyzed based on vaccination status and viral shedding time(VST).The least absolute shrinkage and selection operator(LASSO)regression and 5-fold cross-validation were applied to screen factors linked to the rate of the *** linear models were further applied to estimate the odds ratios for factors influencing the ***:The median VST of unvaccinated patients was 13(11-16)days,which was longer than that of patients vaccinated with one or two doses(11[9-13]days)and with completed booster doses(11[8-12]days).A LASSO regression model and 5-fold cross-validation showed that age of≥60 years(β=0.01),pneumonia(β=0.53),and higher number of comorbidities(β=0.69)were positively associated with the VST,whereas the platelet count(β=-8.0×10-5)was inversely associated with the *** analysis revealed that the number of vaccinations was significantly associated with a decreased VST among patients with renal dysfunction(odds ratio[OR],0.65;95%confidence interval[CI],0.44-0.97;P=0.034)and patients with two or more comorbidities(OR,0.09;95%CI,0.03-0.28;Pviral clearance of Omicron BA.2 variants,while the protectiveness of vacci

关键词： Omicron Vaccination status viral shedding Platelet Lymphocyte

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Laboratory Diagnosis and Monitoring the viral shedding of SARS-CoV-2 Infection

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The Innovation 2020年第3期1卷 56-62页

作者： Yang Yang Minghui Yang Jing Yuan Fuxiang Wang Zhaoqin Wang Jinxiu Li Mingxia Zhang Jinli Wei Ling Peng Gary Wong Haixia Zheng Weibo Wu Chenguang Shen Mingfeng Liao Kai Feng Jianming Li Qianting Yang Juanjuan Zhao Lei Liu Yingxia Liu Shenzhen Key Laboratory of Pathogen and Immunity National Clinical Research Center for Infectious DiseaseState Key Discipline of Infectious DiseaseShenzhen Third People’s HospitalSecond Hospital Affiliated to Southern University of Science and TechnologyNo.29Bulan RoadLonggang DistrictShenzhen 518112China Institut Pasteur of Shanghai Chinese Academy of SciencesShanghai 200031China

The worldwide epidemic of coronavirus disease 2019(COVID-19)is *** and accurate detection of the causative virus SARSCoV-2 is vital for the treatment and control of *** this study,the comparative sensitivity of different respiratory specimen types were retrospectively analyzed using 3,552 clinical samples from 410 COVID-19 patients confirmed by Guangdong CDC(Center for Disease Control and Prevention).Except for bronchoalveolar lavage fluid(BALF),the sputum possessed the highest positive rate(73.4%–87.5%),followed by nasal swabs(53.1%–85.3%)for both severe and mild cases during the first 14 days after illness onset(d.a.o.).viral RNA could be detected in all BALF samples collected from the severe group within 14 *** lasted up to 46 ***,although viral RNA was negative in the upper respiratory samples,it was also positive in BALF samples in most cases from the severe group during ***,no viral RNA was detected in BALF samples from the mild *** typical ground-glass opacity observed via computed tomographic scans,no viral RNA was detected in the first three or all upper respiratory tract specimens from some COVID-19 *** conclusion,sputum is most sensitive for routine laboratory diagnosis of COVID-19,followed by nasal *** of viral RNA in BALF improves diagnostic accuracy in severe COVID-19 patients.

关键词： SARS-COV-2 COVID-19 MOLECULAR DIAGNOSIS RESPIRATORY SPECIMENS viral shedding

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Comparable outcomes but higher risks of prolonged viral RNA shedding duration and secondary infection in cancer survivors with COVID-19: A multi-center, matched retrospective cohort study

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Oncology and Translational Medicine 2020年第6期6卷 237-246页

作者： Hui Peng Sheng Wang Qi Mei Yuhong Dai Jian Li Ming Li Kathrin Halfter Xueyan Jiang Qin Huang Lei Wang Wei Wei Ru Liu Zhen cao Motuma Yigezu Daba Fangfang Wang Bingqing Zhou Hong Qiu Xianglin Yuan Department of Oncology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Radiotherapy Zhongda HospitalMedical College of Southeast UniversityNanjing 210009China Institute of Experimental Immunology University Clinic of Rheinische Friedrich-Wilhelms-UniversityBonn 53127Germany Department of Oncology Wuhan Pulmonary HospitalWuhan 430030China Tumor Register Munich Ludwig-Maximilian-UniversityMunich 81377Germany Dangyang People’s Hospital Yichang 444100China Department of Medical Affairs Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Pulmonary Vascular and General Medicine Fuwai Yunnan Cardiovascular HospitalKunming 650102China Wuhan Wuchang Hospital Wuhan 430030China

Results Sixty-one cancer survivors and 183 matched non-cancer patients were screened from 2,828 COVID-19 infected patients admitted to 4 hospitals in Wuhan,*** median ages of the cancer survivor cohort and non-cancer patient cohort were 64.0(55.0–73.0)and 64.0(54.0–73.5),respectively(P=0.909).Cancer survivors reported a higher incidence of symptom onset than non-cancer ***(80.3%vs.65.0%;P=0.026)was the most prevalent symptom,followed by cough(65.6%vs.37.7%;Pviral RNA shedding duration(32 days[IQR 26.0–46.0]vs.24.0 days[IQR 18.0–33.0];AHR=0.54;95%CI:0.38–0.80;Pviral shedding,but comparable risks of the development of severe events and *** is helpful for clinicians to take tailored measures to treat cancer survivors with COVID-19.

关键词： COVID-19 SARS-CoV-2 cancer survivor prognosis viral shedding mortality

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Comparison of Clinical and Epidemiological Characteristics of Asymptomatic and Symptomatic SARS-CoV-2 Infection in Children

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Virologica Sinica 2020年第6期35卷 803-810页

作者： Jiehao Cai Xiangshi Wang Jun Zhao Yanling Ge Jin Xu He Tian Hailing Chang Aimei Xia Jiali Wang Jinqiang Zhang Zhongqiu Wei Jingjing Li Chuning Wang Jianshe Wang Qirong Zhu Xiaowen Zhai Mei Zeng Department of Infectious Diseases Children’s Hospital of Fudan UniversityShanghai 201102China Department of Pediatrics Shanghai Public Health Clinical Center of Fudan UniversityShanghai 201102China Department of Clinical Laboratory Children’s Hospital of Fudan UniversityShanghai 201102China Department of Infectious Diseases Xiamen Children’s HospitalChildren’s Hospital of Fudan University Xiamen BranchShanghai 201102China Department of Hematology Children’s Hospital of Fudan UniversityShanghai 201102China

To understand the epidemiological and clinical features of the symptomatic and asymptomatic pediatric cases of COVID-19,we carried out a prospective study in Shanghai during the period of January 19 to April 30,2020.A total of 49 children(mean age 11.5±5.12 years)confirmed with SARS-CoV-2 infection were enrolled in the study,including 11(22.4%)domestic cases and 38(77.6%)imported ***(81.8%)local cases and 12(31.6%)imported cases had a definitive epidemiological ***-eight(57.1%)were symptomatic and 21(42.9%)were *** asymptomatic nor symptomatic cases progressed to severe *** mean duration of viral shedding for SARS-CoV-2 in upper respiratory tract was 14.1±6.4 days in asymptomatic cases and 14.8±8.4 days in symptomatic cases(P>0.05).Forty-five(91.8%)cases had viral RNA detected in *** mean duration of viral shedding in stool was 28.1±13.3 days in asymptomatic cases and 30.8±18.6 days in symptomatic participants(P>0.05).Childrenviral RNA in stool for a longer duration than school-aged children(Pviral RNA in a similar pattern as symptomatic cases *** is of particular concern that asymptomatic individuals are potentially seed transmission of SARS-CoV-2 and pose a challenge to disease control.

关键词： SARS-CoV-2 infection Children Epidemiology viral shedding Seropositivity

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viral and Antibody Kinetics of COVID-19 Patients with Different Disease Severities in Acute and Convalescent Phases:A 6-Month Follow-Up Study

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Virologica Sinica 2020年第6期35卷 820-829页

作者： Xiaoyong Zhang Suwen Lu Hui Li Yi Wang Zhen Lu Zhihong Liu Qingtao Lai Yali Ji Xuan Huang Yongyin Li Jian Sun Yingsong Wu Xiaoning Xu Jinlin Hou State Key Laboratory of Organ Failure Research Guangdong Provincial Key Laboratory of Viral Hepatitis ResearchDepartment of Infectious DiseasesNanfang HospitalSouthern Medical UniversityGuangzhou 510000China Department of Laboratory Medicine The People’s Hospital of HonghuJingzhou 433200China Institute of Antibody Engineering School of Laboratory Medicine and BiotechnologySouthern Medical UniversityGuangzhou 510000China Hepatology Unit Shenzhen HospitalSouthern Medical UniversityShenzhen 518000China Centre for Immunology and Vaccinology Chelsea&Westminster HospitalFaculty of MedicineImperial CollegeLondon W6UK

Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has spread rapidly around the world,posing a major threat to human health and the ***,long-term data on viral shedding and the serum antibody responses in COVID-19 patients are still ***,we report the clinical features,viral RNA loads,and serum antibody levels in a cohort of 112 COVID-19 patients admitted to the Honghu People’s Hospital,Hubei Province,***,5.36%(6/112)of patients showed persistent viral RNA shedding(>45 days).The peak viral load was higher in the severe disease group than in the mild group(median cycle threshold value,36.4 versus 31.5;P=0.002).For most patients the disappearance of IgM antibodies occurred approximately 4–6 weeks after symptoms onset,while IgG persisted for over 194 days after the onset of symptoms,although patients showed a 46%reduction in antibodies titres against SARS-CoV-2 nucleocapsid protein compared with the acute *** also studied18 asymptomatic individuals with RT-qPCR confirmed SARS-CoV-2 infection together with 17 symptomatic patients,and the asymptomatic individuals were the close contacts of these symptomatic *** IgG seroconversion and lower IgM seropositive rates were observed in asymptomatic *** data indicate that higher viral loads and stronger antibody responses are related to more severe disease status in patients with SARS-CoV-2 infection,and the antibodies persisted in the recovered patient for more than 6 months so that the vaccine may provide protection against SARS-CoV-2 infection.

关键词： Coronavirus disease 2019(COVID-19) Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) viral shedding Antibody response Disease severity

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