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Review
. 2020 Jun;53(3):473-480.
doi: 10.1016/j.jmii.2020.03.021. Epub 2020 Mar 28.

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

Yu-Han Xing  1 , Wei Ni  2 , Qin Wu  2 , Wen-Jie Li  2 , Guo-Ju Li  2 , Wen-Di Wang  2 , Jian-Ning Tong  2 , Xiu-Feng Song  2 , Gary Wing-Kin Wong  3 , Quan-Sheng Xing  4
Affiliations
Review

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

Yu-Han Xing et al. J Microbiol Immunol Infect. 2020 Jun.

Abstract

Objective: To determine the dynamic changes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in respiratory and fecal specimens in children with coronavirus disease 2019 (COVID-19).

Methods: From January 17, 2020 to February 23, 2020, three paediatric cases of COVID-19 were reported in Qingdao, Shandong Province, China. Epidemiological, clinical, laboratory, and radiological characteristics and treatment data were collected. Patients were followed up to March 10, 2020, and dynamic profiles of nucleic acid testing results in throat swabs and fecal specimens were closely monitored.

Results: Clearance of SARS-CoV-2 in respiratory tract occurred within two weeks after abatement of fever, whereas viral RNA remained detectable in stools of pediatric patients for longer than 4 weeks. Two children had fecal SARS-CoV-2 undetectable 20 days after throat swabs showing negative, while that of another child lagged behind for 8 days.

Conclusions: SARS-CoV-2 may exist in children's gastrointestinal tract for a longer time than respiratory system. Persistent shedding of SARS-CoV-2 in stools of infected children raises the possibility that the virus might be transmitted through contaminated fomites. Massive efforts should be made at all levels to prevent spreading of the infection among children after reopening of kindergartens and schools.

Keywords: COVID-19; Fecal shedding; Pediatric patient; SARS-CoV-2.

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Conflict of interest statement

Declaration of Competing Interest None reported.

Figures

Figure 1
Figure 1
Epidemiologic linkage of three pediatric COVID-19 cases.
Figure 2
Figure 2
Transverse chest computed tomographic images.
Figure 3
Figure 3
Dynamic profile of SARS-CoV-2 RNA in respiratory and fecal specimens.
Figure 4
Figure 4
Chronological changes in RT–PCR testing results after hospital admission.
See this image and copyright information in PMC

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