{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T14:50:40Z","timestamp":1746715840847,"version":"3.40.5"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"\n BACKGROUND<\/jats:title>\n Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a respiratory virus that can cause gastrointestinal (GI) symptoms, with studies demonstrating detection of stool viral RNA weeks after respiratory tract clearance. It is unknown if children who test negative for SARS-CoV-2 on a nasopharyngeal (NP) swab may be shedding the virus in their stool.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE<\/jats:title>\n To measure the prevalence of SARS-CoV-2 stool shedding in children with positive and negative SARS-CoV-2 NP polymerase chain reactions (PCR) tests, and to determine clinical factors associated with GI shedding.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n In this cross-sectional study, we enrolled hospitalized patients 0 to 21 years old with a positive or a negative SARS-CoV-2 NP PCR test who had respiratory and\/or GI symptoms. Participants were surveyed, and stool samples were sent for viral PCR testing. Fisher\u2019s exact test was used to evaluate bivariate associations of stool PCR test positivity with categorical variables.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Sixty-seven patients were consented; 34 patients did not provide stool samples so 33 patients were included: 17 NP-positive and 16 NP-negative for SARS-CoV-2. Eight of the 17 NP-positive patients had a positive stool PCR test for SARS-CoV-2, while none of the 16 SARS-CoV-2 NP-negative patients had a positive result (P &lt; .01). For the 17 SARS-CoV-2 NP-positive patients, GI symptoms were associated with a positive stool PCR test (P = .05) for SARS-CoV-2, but this association was not found for all 33 patients (P = .11). No associations were found with patients in an immunocompromised state or those with a comorbid condition, fever and\/or chills, respiratory symptoms, headache and\/or myalgias, or anosmia and\/or ageusia.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n SARS-CoV-2 GI shedding is common and associated with GI symptoms in NP-positive children, with 47% having positive stool PCRs for SARS-CoV-2. GI shedding was not demonstrated in SARS-CoV-2 NP-negative children.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/hpeds.2021-006304","type":"journal-article","created":{"date-parts":[[2022,1,14]],"date-time":"2022-01-14T08:11:13Z","timestamp":1642147873000},"page":"e78-e85","source":"Crossref","is-referenced-by-count":2,"title":["SARS-CoV-2 Gastrointestinal Shedding in Hospitalized Children"],"prefix":"10.1542","volume":"12","author":[{"given":"Ivy","family":"Tam","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney","family":"McNamara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Dunbar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"O\u2019Connor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gonzalo","family":"Manzano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D.","family":"Cabana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia A.","family":"Hametz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2022,1,14]]},"reference":[{"key":"2022020117483191800_b1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jpeds.2020.11.016","article-title":"SARS-CoV-2 clinical syndromes and predictors of disease severity in hospitalized children and youth","volume":"230","author":"Fernandes","year":"2020","journal-title":"J Pediatr"},{"issue":"18","key":"2022020117483191800_b2","first-page":"1843","article-title":"Detection of SARS-CoV-2 in different types of clinical specimens","volume":"323","author":"Wang","year":"2020","journal-title":"JAMA"},{"issue":"1","key":"2022020117483191800_b3","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1080\/22221751.2020.1729071","article-title":"Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding 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infection","volume":"147","author":"Pinninti","year":"2021","journal-title":"Pediatrics"},{"issue":"4","key":"2022020117483191800_b7","doi-asserted-by":"crossref","first-page":"e00343","DOI":"10.14309\/ctg.0000000000000343","article-title":"Prevalence and persistent shedding of fecal SARS-CoV-2 RNA in patients with COVID-19 infection: a systematic review and meta-analysis","volume":"12","author":"Zhang","year":"2021","journal-title":"Clin Transl Gastroenterol"},{"key":"2022020117483191800_b8","doi-asserted-by":"crossref","first-page":"652842","DOI":"10.3389\/fpubh.2021.652842","article-title":"Characteristics of viral shedding time in SARS-CoV-2 infections: A systematic review and meta-analysis","volume":"9","author":"Yan","year":"2021","journal-title":"Front Public Health"},{"issue":"9","key":"2022020117483191800_b9","doi-asserted-by":"crossref","first-page":"e01369-20","DOI":"10.1128\/JCM.01369-20","article-title":"Utility of stool PCR for the diagnosis of COVID-19: comparison of two commercial platforms","volume":"58","author":"Szymczak","year":"2020","journal-title":"J Clin Microbiol"},{"issue":"4","key":"2022020117483191800_b10","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1038\/s41575-021-00416-6","article-title":"Potential intestinal infection and faecal-oral transmission of SARS-CoV-2","volume":"18","author":"Guo","year":"2021","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"1","key":"2022020117483191800_b11","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1053\/j.gastro.2020.03.065","article-title":"Gastrointestinal manifestations of SARS-CoV-2 infection and virus load in fecal samples from a Hong Kong cohort: systematic review and meta-analysis","volume":"159","author":"Cheung","year":"2020","journal-title":"Gastroenterology"},{"issue":"9","key":"2022020117483191800_b12","doi-asserted-by":"crossref","first-page":"e249","DOI":"10.1097\/INF.0000000000002814","article-title":"Duration of respiratory and gastrointestinal viral 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Isolate if you are sick. Available at: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/if-you-are-sick\/isolation.html. Accessed August 2, 2021"},{"key":"2022020117483191800_b18","unstructured":"CDC. COVID-19 vaccines for moderately to severely immunocompromised people. Available at: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/vaccines\/recommendations\/immuno.html. Accessed October 15, 2021"},{"issue":"12","key":"2022020117483191800_b19","doi-asserted-by":"crossref","first-page":"974","DOI":"10.7326\/M20-0928","article-title":"Probable evidence of fecal aerosol transmission of SARS-CoV-2 in a high-rise building","volume":"173","author":"Kang","year":"2020","journal-title":"Ann Intern Med"},{"issue":"9","key":"2022020117483191800_b20","first-page":"26","article-title":"Environmental transmission of SARS at Amoy Gardens","volume":"68","author":"McKinney","year":"2006","journal-title":"J Environ Health"}],"container-title":["Hospital Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/12\/2\/e78\/1255436\/hpeds.2021-006304.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/12\/2\/e78\/1255436\/hpeds.2021-006304.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T17:54:44Z","timestamp":1643738084000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article\/12\/2\/e78\/184487\/SARS-CoV-2-Gastrointestinal-Shedding-in"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,14]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,1,14]]},"published-print":{"date-parts":[[2022,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/hpeds.2021-006304","relation":{},"ISSN":["2154-1663","2154-1671"],"issn-type":[{"type":"print","value":"2154-1663"},{"type":"electronic","value":"2154-1671"}],"subject":[],"published":{"date-parts":[[2022,1,14]]}}}