Evidence map›Paper›PMID 32852082›Full record

SynthesisAlimentary pharmacology & therapeutics2020

Systematic review with meta-analysis: SARS-CoV-2 stool testing and the potential for faecal-oral transmission.

Amarylle S van Doorn, Berrie Meijer, Chris M A Frampton, Murray L Barclay, Nanne K H de Boer

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Alimentary pharmacology & therapeutics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
86citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

86 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  18. Monoclonal neutralizing antibodies against SARS-COV-2 S protein.American journal of translational research · 2024
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26 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Amarylle S van DoornDepartments of Gastroenterology & Clinical Pharmacology, Christchurch Hospital, Canterbury District Health Board and University of Otago, Christchurch, New Zealand.ORCID https://orcid.org/0000-0003-2961-2097
Berrie MeijerDepartment of Gastroenterology and Hepatology, AG&M Research Institute, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.ORCID https://orcid.org/0000-0002-4760-3269
Chris M A FramptonDepartment of Biostatistics & Medicine, Christchurch Hospital, Canterbury District Health Board and University of Otago, Christchurch, New Zealand.
Murray L BarclayDepartments of Gastroenterology & Clinical Pharmacology, Christchurch Hospital, Canterbury District Health Board and University of Otago, Christchurch, New Zealand.ORCID https://orcid.org/0000-0003-2944-8338
Nanne K H de BoerDepartment of Gastroenterology and Hepatology, AG&M Research Institute, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSince the start of the COVID-19 pandemic, there have been many scientific reports regarding gastrointestinal manifestations. Several reports indicate the possibility of viral shedding via faeces and the possibility of faecal-oral transmission.

aimsTo critically assess the clinical relevance of testing stool samples and anal swabs and provide an overview of the potential faecal-oral transmission of SARS-CoV-2.

methodsA systematic literature search with MeSH terms was performed, scrutinising the Embase database, Google scholar, MEDLINE database through PubMed and The Cochrane Library, including articles from December 2019 until July 7 2020. Data were subsequently analysed with descriptive statistics.

resultsNinety-five studies were included in the qualitative analysis. 934/2149 (43%) patients tested positive for SARS-CoV-2 in stool samples or anal swabs, with positive test results up to 70 days after symptom onset. A meta-analysis executed with studies of at least 10 patients revealed a pooled positive proportion of 51.8% (95% CI 43.8 - 59.7%). Positive faecal samples of 282/443 patients (64%) remained positive for SARS-CoV-2 for a mean of 12.5 days, up to 33 days maximum, after respiratory samples became negative for SARS-CoV-2. Viable SARS-CoV-2 was found in 6/17 (35%) patients in whom this was specifically investigated.

conclusionsViral shedding of SARS-CoV-2 in stool samples occurs in a substantial proportion of patients, making faecal-oral transmission plausible. Furthermore, detection in stool samples or anal swabs can persist long after negative respiratory testing. Therefore, stool sample or anal swab testing should be (re)considered in relation to decisions for isolating or discharging a patient.

Indexed as

AdultBetacoronavirusCoronavirus InfectionsCOVID-19FecesGastrointestinal TractHumansPandemicsPneumonia, ViralSARS-CoV-2Virus Sheddinganal swabCoronavirusCOVID-19faecal-oral transmissionSARS-CoV-2stool test

Identifiers

PMID32852082
PMCPMC7461227

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

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.