摘要
Background Coronavirus disease 2019(COVID-19)has diferent manifestations in pediatric cases.It is assumed that they might present more gastrointestinal symptoms with a diferent viral shedding pattern in gastrointestinal samples.In this systematic review and meta-analysis,we aimed to evaluate the viral shedding pattern in gastrointestinal specimens of children with COVID-19.Methods We searched all published studies in English language in PubMed,Web of Science,and Scopus,up to date as of October 2021.Our search included the term"severe acute respiratory syndrome coronavirus 2,COVID-19,SARS-CoV-2,novel coronavirus,or coronavirus;and shed,excrete,secret,or carriage;and stool or rectal;and children or pediatrics".We included studies evaluating SARS-CoV-2 shedding in gastrointestinal specimens,including rectal swabs and stool samples of children with COVID-19 infection.We excluded duplicated data,case reports,and studies without original data.Results Twelve studies met the eligibility criteria for the qualitative synthesis,10 of which were included in the meta-analysis.The pooled prevalence of gastrointestinal severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)RNA in children with COVID-19 was 86%(95%confdence interval 73%–96%,I 2=62.28%).After respiratory specimen had become negative,72%(43/60)had persistent shedding in gastrointestinal specimens.The gastrointestinal RNA had a positive test result for more than 70 days after symptoms onset.Conclusions Gastrointestinal shedding of SARS-CoV-2 might occur in a substantial portion of children and might persist long after negative respiratory testing.Further research is recommended to fnd the role of SARS-CoV-2 gastrointestinal shedding in transmission in children.
