Assessment of Fecal Viral Shedding Among Children Who Have COVID-19 by Polymerase Chain Reaction

Abstract

Objective: This study aimed to assess fecal viral shedding in children who have been confirmed COVID-19 by real time polymerase chain reaction (RT-PCR).

Material and Methods: We enrolled fifty inpatient children who have been confirmed COVID-19 during first wave of outbreak in our region. All of the patients have been twice confirmed by RT-PCR within nasopharyngeal swabs. Each case was evaluated with clinical data, laboratory tests and rectal swabs. The rectal swabs were obtained five days after nasopharyngeal positivity. The clinical data was recorded within two basic categories, including common symptoms or digestive symptoms. Detection of SARS-CoV-2 in rectal swabs was performed by RT-PCR method.

Results: Fifteen patients (30%) had digestive symptoms. On the 5th day, 50 rectal swabs were studied with PCR-RT. Only one of them was positive (2%). The only patient who was positive for SARS-CoV-2 on rectal swab was a symptomatic threeand-a-half-year-old girl. The patient, who became asymptomatic in the follow-up, was retested with a nasopharyngeal swab one week later, the result was negative and she was discharged on the 10th day. The second rectal smear of the patient was negative.

Conclusion: We found very low rate (2%) fecal viral shedding with rectal swab PCR among children who have been confirmed COVID-19 by nasopharyngeal swab PCR. We thought that this result was due to the mild clinical course of the patients who has been diagnosed with COVID-19 we followed up. However, fecal oral transmission might still matter in children.

Keywords

• COVID-19
• fecal shedding
• children
• Polymerase Chain Reaction

COVID-19 Tanılı Çocuklarda Polimeraz Zincir Reaksiyonu ile Fekal Viral Yayılımın Değerlendirilmesi

Abstract

Amaç: Bu çalışmada nazal sürüntüde real-time polimeraz zincir reaksiyonu (RT-PCR) ile COVID-19 tanısı doğrulanmış çocuklarda , fekal viral bulaşmayı değerlendirmeyi amaçladık.

Gereç ve Yöntemler: Bölgemizdeki ilk salgın dalgası sırasında COVID-19 tanılı yatarak tedavi gören elli çocuğu çalışmaya dahil ettik. Tüm hastaların nazofaringeal sürüntüleri RT-PCR ile iki kez pozitifti. Her vaka klinik veriler, laboratuvar testleri ve rektal sürüntü ile değerlendirildi. Rektal sürüntüler nazofarengeal pozitiflikten beş gün sonra alındı. Klinik veriler, genel semptomlar veya sindirim semptomları dahil olmak üzere iki temel kategoride kaydedildi. Rektal sürüntülerde SARS-CoV-2’nin tespiti, RNA’ya bağımlı RNA polimeraz genini hedefleyen RT-PCR yöntemi ile gerçekleştirildi.

Bulgular: On beş hastada (%30) sindirim sistemi ilişkili belirtiler görüldü. Hastalarda yoğun bakıma veya daha fazla tedaviye ihtiyaç duyulmadı. 5. günde PCR-RT ile 50 rektal sürüntü çalışıldı. Bunlardan sadece biri pozitifti (%2). Rektal sürüntüde SARS-Cov 2 pozitif gelen tek hasta semptomatik ve üç buçuk yaşında bir kızdı. İzlemde asemptomatik hale gelen hasta bir hafta sonra nazofaringeal sürüntü ile tekrar test edildi, sonucu negatif geldi ve 10. gün taburcu edildi. Olgunun ikinci rektal sürüntüsü negatif olarak sonuçlandı.

Sonuç: Nazofaringeal sürüntü PCR ile COVID-19 doğrulanmış çocuklar arasında rektal sürüntü PCR ile dışkıda viral bulaşma oranının çok düşük olduğunu (%2) bulduk. Bu sonucun, takip ettiğimiz COVID-19 tanısı alan hastaların hafif klinik seyrine bağlı olduğunu düşündük. Bununla birlikte, fekal oral yolla bulaşma çocuklarda hala önemini korumaktadır.

Keywords

• COVID-19
• Fekal Yayılım
• Çocuk
• Polimeraz zincir reaksiyonu

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