ReviewThe Science of the total environment2020
Shedding of SARS-CoV-2 in feces and urine and its potential role in person-to-person transmission and the environment-based spread of COVID-19.
Review in The Science of the total environment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 225 papers, 5 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
225 citing papers in PubMed, 5 syntheses or guidelines pooled it, 421 citations in OpenAlex.
- Recent progress on wastewater-based epidemiology for COVID-19 surveillance: A systematic review of analytical procedures and epidemiological modeling.The Science of the total environment · 2023Pooled it
- Correlation between SARS-CoV-2 RNA concentration in wastewater and COVID-19 cases in community: A systematic review and meta-analysis.Journal of hazardous materials · 2023Pooled it
- SARS-CoV-2 effects on sperm parameters: a meta-analysis study.Journal of assisted reproduction and genetics · 2022Pooled it
- SARS-CoV-2 shedding sources in wastewater and implications for wastewater-based epidemiology.Journal of hazardous materials · 2022Pooled it
- Wastewater surveillance to infer COVID-19 transmission: A systematic review.The Science of the total environment · 2022Pooled it
- Efficacy of Niclosamide vs Placebo in SARS-CoV-2 Respiratory Viral Clearance, Viral Shedding, and Duration of Symptoms Among Patients With Mild to Moderate COVID-19: A Phase 2 Randomized Clinical Trial.JAMA network open · 2022Trial
- Longitudinal detection and genetic characterization of feline coronavirus in a captive cheetah population.The Journal of general virology · 2026Article
- DETECTION OF SARS-COV-2 IN MULTIPLE CLINICAL SPECIMENS: A PILOT PREVALENCE STUDY FROM NORTHEAST NIGERIA.Annals of Ibadan postgraduate medicine · 2026Article
- Viral genotype and the pace of epidemic waves: an assessment from SARS-CoV 2 genomics and wastewater surveillance data.Archives of virology · 2026Article
- Article
- Seasonal Variations in the Occurrence of SARS-CoV-2 RNA Recovered from Wastewater Treatment Facilities (WWTFs) Within South Africa.Microorganisms · 2026Article
- Environmental metagenomics enhances detection of circulating viruses from live poultry markets in Cambodia.Nature communications · 2026Article
- Serological evidence of SARS-CoV-2 exposure in marine mammals in the United States between 2020 and 2025.PloS one · 2026Article
- Localized wastewater surveillance showed correlation but no early warning during Bengaluru's Omicron wave.PLOS global public health · 2026Article
- Evaluation of wastewater SARS-CoV-2 surveillance for monitoring COVID-19 trends and early warning in Sweden, 2023-2024.PloS one · 2026Article
- Long-term biological surveillance of SARS-CoV-2 in critical points for municipal sewage catchment in light of wastewater-based epidemiology, public health and environmental hygiene.Scientific reports · 2025Article
- Wastewater-Based Tracking SARS-CoV-2 RNA and Estimating Infected Population in Industrial Setting After Songkran Festival-Thailand Traditional New Year in 2023.Food and environmental virology · 2025Article
- Performance and suitability of wastewater based-surveillance for SARS-CoV-2 RNA in public schools.Scientific reports · 2025Article
- Long-Term Sewage Survey of SARS-CoV-2, Influenza A and Respiratory Syncytial Virus (RSV), and Correlation to Human Cases in a City with One Million Inhabitants.Microorganisms · 2025Article
- Long term assessment of SARS-CoV-2 in wastewater and the transition to evaluate additional viral targets.The Science of the total environment · 2025Article
165 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The recent detection of SARS-CoV-2 RNA in feces has led to speculation that it can be transmitted via the fecal-oral/ocular route. This review aims to critically evaluate the incidence of gastrointestinal (GI) symptoms, the quantity and infectivity of SARS-CoV-2 in feces and urine, and whether these pose an infection risk in sanitary settings, sewage networks, wastewater treatment plants, and the wider environment (e.g. rivers, lakes and marine waters). A review of 48 independent studies revealed that severe GI dysfunction is only evident in a small number of COVID-19 cases, with 11 ± 2% exhibiting diarrhea and 12 ± 3% exhibiting vomiting and nausea. In addition to these cases, SARS-CoV-2 RNA can be detected in feces from some asymptomatic, mildly- and pre-symptomatic individuals. Fecal shedding of the virus peaks in the symptomatic period and can persist for several weeks, but with declining abundances in the post-symptomatic phase. SARS-CoV-2 RNA is occasionally detected in urine, but reports in fecal samples are more frequent. The abundance of the virus genetic material in both urine (ca. 10
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.