Prolonged rectal shedding of SARS-CoV-2 in a 22-day-old-neonate: a case report

Holm-Jacobsen, Julie Niemann; Vonasek, Julia; Hagstrøm, Søren; Donneborg, Mette Line; Sørensen, Susanne

doi:10.1186/s12887-021-02976-7

Cited by 7 publications

(5 citation statements)

References 44 publications

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“…Cho and Ha [ 8 ] Korea 45 days 1 Nasal swab, urine and serum specimens, stool specimens RT-PCR 21 days > 12 weeks Diarrhea 2. Holm-Jacobsen et al [ 24 ] Denmark 22 days 1 Pharyngeal and rectal swabs RT-PCR 11 days 45 days N/A 3. Uda et al [ 27 ] Japan 21 months 1 Nasopharyngeal and stool samples RT-PCR 13 days 61 days N/A 4.…”

Section: Resultsmentioning

confidence: 99%

Prolonged viral shedding in feces of children with COVID-19: a systematic review and synthesis of data

Zhang

Liu

et al. 2022

Eur J Pediatr

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During the coronavirus disease 2019 (COVID-19) epidemic, many reports have indicated that children shed the virus longer than adults in stool, and that most of the children had mild or even asymptomatic infections, which increased the potential risk for feces to be a source of contamination and may play an important role in the spread of the virus. In this review, we collected relevant literature to summarize the duration of fecal viral shedding in children with COVID-19. We found that in about 60% of the cases, the fecal shedding time was between 28 and 42 days, which was much longer than that of adults. We further explored the possible reason for prolonged shedding and its the potential impact. The poor hand hygiene practices of children, their tendency to swallow sputum and/or saliva, the significant difference in expression of angiotensin-converting enzyme 2 (ACE2) in intestine between children and adults, and the variance in immune status and intestinal microbiome could be considered as potential casual agents of longer fecal viral shedding duration of children. Conclusion : Children with COVID-19 show prolonged fecal shedding compared to adults. Several mechanisms may be involved in the longer fecal viral shedding. Viral shedding in the stool could be contributing to a possible route of transmission. Therefore, we think that further preventive measures in children should be taken to reduce the spread of the disease. What is Known: • Children with COVID-19 are more likely to have asymptomatic infections and to experience mild symptoms. • Some patients continue to shed the virus in feces, despite respiratory samples testing negative. What is New: • Children with COVID-19 carried a longer-term fecal viral shedding than adults. • The poor hand hygiene practices of children, their tendency to swallow sputum and/or saliva, the difference in expression of ACE2 in intestine between children and adults, and the variance in immune status and intestinal microbiome could be considered as potential casual agents of longer fecal viral shedding duration of children.

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Section: Resultsmentioning

confidence: 99%

Prolonged viral shedding in feces of children with COVID-19: a systematic review and synthesis of data

Zhang

Liu

et al. 2022

Eur J Pediatr

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“…Moreover, several data points regarding the shedding duration in stool samples suggest prolonged periods of up to 70 days or more (3,19,42,74). The prolonged shedding period was mainly related to severe cases requiring hospitalization or immunocompromised patients (39,75).…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 excretion kinetics in nasopharyngeal and stool samples from the pediatric population

Khemiri,

Gdoura,

Ben Halima

et al. 2023

Front. Med.

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BackgroundThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for serious respiratory infections in humans. Even in the absence of respiratory symptoms, gastrointestinal (GI) signs were commonly reported in adults and children. Thus, oral–fecal transmission was suspected as a possible route of infection. The objective of this study was to describe RNA shedding in nasopharyngeal and stool samples obtained from asymptomatic and symptomatic children and to investigate virus viability.MethodsThis study included 179 stool and 191 nasopharyngeal samples obtained from 71 children, which included symptomatic (n = 64) and asymptomatic (n = 7) ones. They were collected every 7 days from the onset of the infection until negativation. Viral RNA was detected by real-time RT-PCR, targeting the N and ORF1 genes. Whole-genome sequencing was performed for positive cases. Viral isolation was assessed on Vero cells, followed by molecular detection confirmation.ResultsAll cases included in this study (n = 71) were positive in their nasopharyngeal samples. SARS-CoV-2 RNA was detected in 36 stool samples obtained from 15 out of 71 (21.1%) children; 13 were symptomatic and two were asymptomatic. Excretion periods varied from 7 to 21 days and 7 to 14 days in nasopharyngeal and fecal samples, respectively. Four variants were detected: Alpha (n = 3), B.1.160 (n = 3), Delta (n = 7), and Omicron (n = 1). Inoculation of stool samples on cell culture showed no specific cytopathic effect. All cell culture supernatants were negative for RT-qPCR.ConclusionOur study demonstrated nasopharyngeal and fecal shedding of SARS-CoV-2 RNA by children up to 21 and 14 days, respectively. Fecal shedding was recorded in symptomatic and asymptomatic children. Nevertheless, SARS-CoV-2 was not isolated from positive stool samples.

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“…Wastewater-based epidemiology is a surveillance tool for the collection, extraction, and detection of infectious agents present in a population using wastewater as a sample source [7]. The technique has been employed for the detection of illicit drugs [8], antimicrobial resistance (AMR) [9], viruses such as poliovirus [10], hepatitis A virus, norovirus outbreaks [11] and SARS-CoV-2 [12] [13] [14]. COVID-19-infected individuals usually shed the virus in the nasal, oropharyngeal, and gastrointestinal tract [15] [16] [17] [18].…”

Section: Introductionmentioning

confidence: 99%

“…The major benefits of the wastewater-based epidemiology approach are that it is non-invasive, unbiased, in-expensive, and can serve as an early-warning system for SARS-CoV-2 emergence due to its inherent inclusiveness, and the ability to capture both asymptomatic and symptomatic cases [14] [20] [21]. Additionally, wastewater represents a pooled sample from a population for its ability to blend the viruses coming from different sources such as hand washing, sputum, feaces, and fomites contributed by both symptomatic and asymptomatic cases [22].…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Analysis of Wastewater Confirms Dominant Circulation of SARS-CoV-2 Delta Variant in Nairobi, Kenya, between April 2021 and August 2021

Sichamba¹,

Wamunyokoli²,

Borus³

et al. 2022

AJMB

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Wastewater surveillance has been applied in various parts of the world to monitor the introduction and transmissions of SARS-CoV-2 variants in a population. The knowledge of SARS-CoV-2 variants circulating in a population is critical to COVID-19 management and timing of the application of public health countermeasures. Contrary to the routine clinical surveillance of SARS-CoV-2 where cases from asymptomatic patients are often underreported, wastewater surveillance offers an unbiased tool for monitoring the extent of SARS-CoV-2 transmissions in a community. The present study aimed to characterize SARS-CoV-2 variants that circulated in Nairobi County, Kenya, between April 2021 and August 2021 utilizing wastewater samples. Viral RNA was extracted from wastewater samples, followed by SARS-CoV-2 screening by real-time RT-qPCR before targeted sequencing of the Spike gene. Forty samples were analyzed, of which 50% (n = 20) tested positive for SARS-CoV-2 by real-time RT-qPCR. Of these, 45% (n = 9) were successfully amplified by RT-PCR and sequenced. The majority (78%, 7/9) of the viruses belonged to the Delta (B.1.617.2) lineage of SARS-CoV-2, while a minority (22%) belonged to the Alpha (B.1.1.7) and Alpha-Delta lineages. Phylogenetic analysis of the SARS-COV-2 delta lineage strains revealed scattered clustering of the Kenyan viruses among the global strains included in the analysis, suggesting different introductory routes into the country.

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Prolonged rectal shedding of SARS-CoV-2 in a 22-day-old-neonate: a case report

Cited by 7 publications

References 44 publications

Prolonged viral shedding in feces of children with COVID-19: a systematic review and synthesis of data

Prolonged viral shedding in feces of children with COVID-19: a systematic review and synthesis of data

SARS-CoV-2 excretion kinetics in nasopharyngeal and stool samples from the pediatric population

A Retrospective Analysis of Wastewater Confirms Dominant Circulation of SARS-CoV-2 Delta Variant in Nairobi, Kenya, between April 2021 and August 2021

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