Prolonged viral shedding in feces of pediatric patients with coronavirus disease 2019

Xing, Yuhan; Ni, Wei; Wu, Qin; Li, Wenjie; Li, Guoju; Wang, Wendi; Tong, Jianning; Song, Xingxing; Wong, Gary; Xing, Quansheng

doi:10.1016/j.jmii.2020.03.021

Cited by 296 publications

(335 citation statements)

References 17 publications

(11 reference statements)

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“…However, there have been no reports of faecal-oral transmission of the COVID-19 virus to date. 4 In a study of Xing et al, clearance of SARS-CoV-2 in respiratory tract occurred within two weeks after the decrease in fever, whereas viral RNA remained detectable in stools of pediatric patients for longer than 4 weeks [21].…”

Section: Transmissionmentioning

confidence: 99%

Novel coronavirus disease (COVID-19) in children

2020

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IntroductionMany cases of pneumonia with an unknown origin were observed in Wuhan, Hubei Province, China [1,2]. It was reported that most of these patients exposed to the Huanan Seafood Wholesale Market. The disease spread rapidly, to other parts of China, and then globally, to many countries across six continents.On January 3, 2020, the Chinese Center for Disease Control and Prevention (China CDC) confirmed a novel member of enveloped RNA coronavirus as the cause of this disease 1 . The World Health Organization (WHO) described it as the 2019 novel coronavirus (2019-nCoV) on January 7, 2020. After a short period, WHO has declared the COVID-19 a public health emergency of international concern on January 30 2 . Since then, the disease affected 1 Tan WJ, Zhao X, Ma XJ. A novel coronavirus genome identified in a cluster of pneumonia cases-Wuhan, China 2019−2020. China CDC Weekly 2020; 2:61-2. 2 World Health Organization (2020). WHO Director-General's statement on IHR Emergency Committee on Novel Coronavirus (2019-nCoV) [online]. Website https://www.who.int/dg/speeches/detail/who-director-general-s-statement-on-ihr-emergency-committeeon-novel-coronavirus-(2019-nCov) [accessed 03 March 2020]. 3 World Health Organization (2020). Coronavirus disease 2019 (COVID-19) Situation Report -80 [online]. Website https://www. who.int/docs/default-source/coronaviruse/situation-reports/20200409-sitrep-80-covid-19.pdf?sfvrsn=1b685d64_4 [accessed 10 April 2020]. more than 177 countries globally. On February 11, 2020, this illness was named as the 2019 coronavirus disease (COVID-19) by WHO [3].The first cases detected in Europe were reported from France on January 24, 2020, many European countries reported cases following France. In a short time, many people from many different countries in Europe were affected [4]. The first case from Turkey was reported on March 13, 2020. By April 9, there were 1,436,198 confirmed COVID-19 cases in the world, and total deaths were 85,522 3 .The first confirmed pediatric case of Severe Acute Respiratory Syndrome (SARS)-CoV-2 infection was reported in Shenzhen on January 20 [5], and by January 31, more than 20 pediatric cases were reported in China Abstract: Coronavirus disease (COVID-19) was firstly reported at the end of 2019. The disease rapidly spread all around the world in a few months and was declared a worldwide pandemic by WHO in March 2020. By April 9, there were 1,436,198 confirmed COVID-19 cases in the world, nearly with 6% mortality rate. This novel infectious disease causes respiratory tract illness that may generally occur as mild upper respiratory tract disease or pneumonia. In older patients and/or patients with underlying conditions, it may result in acute respiratory distress syndrome, multi organ failure and even death. According to the current literature, children account approximately for 1%-5% of diagnosed COVID-19 cases. Generally, COVID-19 seems to be a less severe disease for children than adults. Approximately 90% of pediatric patients are diagnosed as asymptomatic, mild, o...

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Section: Transmissionmentioning

confidence: 99%

Novel coronavirus disease (COVID-19) in children

2020

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“…Since the identification of the first few cases of COVID-19, numerous studies have mushroomed with a focus on the epidemiological, clinical, laboratory, and radiological characteristics of infected patients, prompting the development of diagnosis and treatment strategies (Ai et al, 2020;Chen et al, 2020;Cortegiani et al, 2020;Huang et al, 2020;Xing et al, 2020;. However, there is limited data regarding the potential predictors of negative conversion with COVID-19 patients.…”

Section: Introductionmentioning

confidence: 99%

“…Journal Pre-proof J o u r n a l P r e -p r o o f epidemic center, took a rapid response in the face of COVID-19 outbreak. The local government and municipal center for disease control and prevention in Qingdao has launched series of aggressive measures to screen, quarantine, diagnose, treat and monitor suspected patients and their close contacts (Jia et al, 2020;Xing et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with negative conversion of viral RNA in patients hospitalized with COVID-19

Xing

Jia

et al. 2020

Science of The Total Environment

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127

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Journal Pre-proof J o u r n a l P r e -p r o o f Journal Pre-proof J o u r n a l P r e -p r o o f 3 Abstract Factors associated with negative conversion of SARS-CoV-2 RNA in hospitalized patients have not yet been systematically determined. We conducted a retrospective cohort study of COVID-19 patients in Qingdao, China. Both univariate and multivariate analysis were performed to identify independent factors for time to viral RNA negative conversion. Data on patients with re-detectable viral RNA after showing negative on RT-PCR test (intermittent negative status) were also analyzed. A total of 59 patients confirmed with COVID-19 were included in this study, with a median duration of 1 (interquartile range, IQR: 0-2) day from symptom onset to hospital admission. Median communicable period (from first day of positive nucleic acid test to first day of consecutive negative results) was 14 (IQR: 10-18) days, and 7 (IQR: 6-10) days for 10 patients with intermittent negative results. Age older than 45 years (hazard ratio, HR: 0.378; 95% confidence interval, CI: 0.205-0.698) and chest tightness (HR: 0.290; 95%CI: 0.091-0.919) were factors indepently affecting negative conversion of SARS-CoV-2 RNA. Headache (odds ratio: 7.553; 95%CI: 1.011-28.253)was significantly associated with intermittent negative status, with a predicted probability of 60%. Older age and chest tightness were independently associated with delayed clearance of SARS-CoV-2 RNA in hospitalized patients. These predictors would provide a new perspective on early identification of patients with prolonged viral shedding and facilitate optimal isolation protocols and treatment strategies.

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“…Since the time of SARS-CoV-2003, there existed convincing evidence that aerosol-generating procedures (AGP) could potentially result in a wider human-to-human coronavirus droplet transmission radius [1]. There have been reports of COVID-19 being found in faeces and cerebral spinal fluid, but none in vaginal and amniotic fluid [2][3][4][5]. There have yet to be any studies assessing COVID-19 in peritoneal fluid.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 not detected in peritoneal fluid: a case of laparoscopic appendicectomy for acute appendicitis in a COVID-19-infected patient

Ngaserin

Koh

Ong

et al. 2020

Langenbecks Arch Surg

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Purpose COVID-19 greatly affected millions and affected the way we practice with heightened posture in the way we treat surgical patients. Surgical consensus guidelines are recommending caution in the use of laparoscopy for the theoretical possibility of viral transmission from aerosolization of tissue and peritoneal fluid during surgery. However, there has yet to be proof of COVID-19 being present in peritoneal fluid, justifying the consensus statements. We aim to assess the presence of COVID-19 in peritoneal fluid. Methods We performed a laparoscopic appendicectomy for a COVID-19-infected patient with acute appendicitis. Peritoneal fluid and peritoneal washings were collected and sent for COVID-19 PCR. Results The peritoneal fluid sample collected on entry and at the end of the operation was negative for COVID-19 on PCR. The patient had an uneventful recovery from surgery.

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Prolonged viral shedding in feces of pediatric patients with coronavirus disease 2019

Cited by 296 publications

References 17 publications

Novel coronavirus disease (COVID-19) in children

Novel coronavirus disease (COVID-19) in children

Factors associated with negative conversion of viral RNA in patients hospitalized with COVID-19

COVID-19 not detected in peritoneal fluid: a case of laparoscopic appendicectomy for acute appendicitis in a COVID-19-infected patient

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