Evidence map›Paper›PMID 38387982›Full record

SynthesisBMJ open2024

Viral shedding of SARS-CoV-2 in body fluids associated with sexual activity: a systematic review and meta-analysis.

Guilherme Amaral Calvet, Edna Kara, Lianne Gonsalves, Armando Humberto Seuc, Raquel de Vasconcellos Carvalhaes de Oliveira, Soe Soe Thwin, Rodolfo Gomez Ponce de León, Maité Cabrera Gámez, Gilda Monteagudo Peña, Bertha Victoria Rodríguez Pendás and 10 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
3.1field-weighted citation impact, top 9% of its field
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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Effect of SARS-CoV-2 infection on sperm telomere length.Journal of assisted reproduction and genetics · 2025
    Article
  4. Article
  5. Article
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

20 authors at 7 institutions in 6 countries.

Guilherme Amaral Calvet *Oswaldo Cruz Foundation, Rio de Janeiro, Brazil guilherme.calvet@ini.fiocruz.br.ORCID 0000-0002-3545-5238
Edna Kara *Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Lianne GonsalvesDepartment of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.ORCID 0000-0003-2409-5043
Armando Humberto SeucNational Institute of Hygiene Epidemiology and Microbiology, Habana, La Habana, Cuba.
Raquel de Vasconcellos Carvalhaes de OliveiraOswaldo Cruz Foundation, Rio de Janeiro, Brazil.
Soe Soe ThwinDepartment of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Rodolfo Gomez Ponce de LeónLatin American Center for Perinatology Women and Reproductive Health, Montevideo, Uruguay.ORCID 0000-0001-9914-7130
Maité Cabrera GámezNational Institute of Endocrinology and Metabolic Diseases, La Habana, Cuba.
Gilda Monteagudo PeñaNational Institute of Endocrinology and Metabolic Diseases, La Habana, Cuba.
Bertha Victoria Rodríguez PendásNational Institute of Endocrinology and Metabolic Diseases, La Habana, Cuba.
Manuel Gómez AlzugarayNational Institute of Endocrinology and Metabolic Diseases, La Habana, Cuba.
Gisel Ovies CarballoNational Institute of Endocrinology and Metabolic Diseases, La Habana, Cuba.
Duniesky Cintra CalaPan American Health Organization Cuba, La Habana, Cuba.ORCID 0000-0002-2644-0157
Patrícia Machado Quintaes GuimarãesOswaldo Cruz Foundation, Rio de Janeiro, Brazil.
Mercedes BonetDepartment of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Melanie TaylorCenters for Disease Control and Prevention, Atlanta, Georgia, USA.
Anna ThorsonDepartment of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Caron KimDepartment of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.ORCID 0000-0002-3574-4160
Moazzam AliDepartment of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.ORCID 0000-0001-6949-8976
Nathalie BroutetDepartment of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
World Health Organization · CHInstitut des Maladies Métaboliques et Cardiovasculaires · FRFundação Oswaldo Cruz · BRCenters for Disease Control and Prevention · USInstituto de Nutricion e Higiene de los Alimentos · CUPan American Health Organization (Cuba) · CURedCLARA · UY

Funding

World Health Organization 001
6 · The paper itself

Abstract

objectiveTo identify and summarise the evidence on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection and persistence in body fluids associated with sexual activity (saliva, semen, vaginal secretion, urine and faeces/rectal secretion). ELIGIBILITY: All studies that reported detection of SARS-CoV-2 in saliva, semen, vaginal secretion, urine and faeces/rectal swabs. INFORMATION SOURCES: The WHO COVID-19 database from inception to 20 April 2022. RISK OF BIAS ASSESSMENT: The National Institutes of Health tools. SYNTHESIS OF

resultsThe proportion of patients with positive results for SARS-CoV-2 and the proportion of patients with a viral duration/persistence of at least 14 days in each fluid was calculated using fixed or random effects models. INCLUDED STUDIES: A total of 182 studies with 10 023 participants.

resultsThe combined proportion of individuals with detection of SARS-CoV-2 was 82.6% (95% CI: 68.8% to 91.0%) in saliva, 1.6% (95% CI: 0.9% to 2.6%) in semen, 2.7% (95% CI: 1.8% to 4.0%) in vaginal secretion, 3.8% (95% CI: 1.9% to 7.6%) in urine and 31.8% (95% CI: 26.4% to 37.7%) in faeces/rectal swabs. The maximum viral persistence for faeces/rectal secretions was 210 days, followed by semen 121 days, saliva 112 days, urine 77 days and vaginal secretions 13 days. Culturable SARS-CoV-2 was positive for saliva and faeces. LIMITATIONS: Scarcity of longitudinal studies with follow-up until negative results.

interpretationSARS-CoV-2 RNA was detected in all fluids associated with sexual activity but was rare in semen and vaginal secretions. Ongoing droplet precautions and awareness of the potential risk of contact with faecal matter/rectal mucosa are needed. PROSPERO REGISTRATION NUMBER: CRD42020204741.

Indexed as

Body FluidsCOVID-19SARS-CoV-2Sexual BehaviorVirus SheddingFecesFemaleHumansMaleRNA, ViralSalivaSemenVaginaRNA, ViralCOVID-19INFECTIOUS DISEASESPublic health

Identifiers

PMID38387982
PMCPMC10882346
OpenAlexW4392087872

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.