Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From a Hong Kong Cohort: Systematic Review and Meta-analysis

  • DOI: 10.1053/j.gastro.2020.03.065 readcube import

  • Patients: 59 (positive: 9, negative: 50)

  • Samples: unknown (positive: unknown, negative: unknown)

  • Assay: ?

  • Level of quantification: unknown log10 gc per mL

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Cheung et al. conducted a cohort study of 59 patients in Hong Kong and a metaanalysis of existing literature focused on the presence of SARS-CoV-2 RNA in stool samples. They report summary statistics of viral load in their cohort and note that viral RNA concentration was higher in patients with diarrhoea. Individual viral load values are not reported.

Note

Methods for determining viral load are not described and no reference to a particular assay is provided.

The authors reference twelve additional publications that asses viral RNA in stool samples in Fig. 5 of the supplementary material, including

  1. Xiao, F et al. 2020 study of 73 patients (39 had positive stool samples). They do not report quantitative results, and the study is not included here.

  2. Zhang, W et al. 2020 study of two cohorts (39 and 139 patients). Anal swabs were used instead of stool samples, and data were reported as cycle threshold values without conversion to RNA concentration in the original samples, and the study is not included here.

  3. Zhang, J et al. 2020 study of 14 patients (5 had positive stool samples). They do not provide details on the methods used and only report binary results. The study is not included here.

  4. Wang, W et al. 2020 the study is included here.

  5. Young, BE et al. 2020 study of 18 patients (8 had stool samples taken of which 4 were positive). Cycle threshold values are reported (and are similar to Wölfel et al. 2020), but no RNA concentration data are available. The study is not included here.

  6. Kim, JY et al. 2020 study of the first two patients in Korea. Large cycle threshold values were observed in stool samples, but they were not converted to RNA loads. Conversions for respiratory specimen are available, but it is not clear whether they can be used for stool samples. The study is currently not included here.

  7. Yang, Z et al. 2020: study of three patients with positive stool samples. No information on viral RNA load is provided. Note that the study is not presented in English, and conclusions are based on automatic translation. The study is not included here.

  8. Cheng, SC et al. 2020 study of the first case in Taiwan, including only one late stool sample. No viral loads were reported, and the study is not included here.

  9. Holshue, M et al. 2020 study of the first case in the United States, including one stool sample on day seven of illness. Only cycle threshold values were reported, and the study is not included here.

  10. Cai, J et al. 2020 study of ten children with Covid-19. Six had faecal samples tested (5 positive with cycle threshold < 35). No RNA loads were reported, and the study is not included here.

  11. Zeng, L et al. 2020 study of a neonate, but unable to identify testing of stool samples. Note that the study is not presented in English, and conclusions are based on automatic translation. The study is not included here.

  12. Zhang, YH et al. 2020 study of an infant with positive stool samples, but no quantitative information. Note that the study is not presented in English, and conclusions are based on automatic translation. The study is not included here.