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COVID-19 (SARS-CoV-2) in non-airborne body fluids : a systematic review & meta-analysis
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Johnson, Hans, Garg, Megha, Shantikumar, Saran, Thachil, Jecko, Rai, Bhavan, Aboumarzouk, Omar M, Hashim, Hashim and Philip, Joe (2021) COVID-19 (SARS-CoV-2) in non-airborne body fluids : a systematic review & meta-analysis. Turkish Journal of Urology, 47 (2). pp. 87-97. doi:10.5152/tud.2021.20586 ISSN 2149-3235.
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Official URL: https://doi.org/10.5152/tud.2021.20586
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been predominantly respiratory. This study aimed to evaluate the presence of virus in non-airborne body fluids as transmission vehicles. Medline, EMBASE, and Cochrane Library databases were searched from December 01, 2019, to July 01, 2020, using terms relating to SARS-CoV-2 and non-airborne clinical sample sources (feces, urine, blood, serum, serum, and peritoneum). Studies in humans, of any design, were included. Risk of bias assessment was performed using the Quality Assessment of Diagnostic Accuracy 2 tool. Preferred Reporting Items for Systematic Reviews & Meta-Analyses) guidelines were used for abstracting data. If ≥5 studies reported proportions for the same non-respiratory site, a meta-analysis was conducted using either a fixed or random-effects model, depending on the presence of heterogeneity. A total of 22 studies with 648 patients were included. Most were cross-sectional and cohort studies. The SARS-CoV-2 RNA was most frequently detected in feces. Detectable RNA was reported in 17% of the blood samples, 8% of the serum, 16% in the semen, but rarely in urine. Prevalence of SARS-CoV-2 in non-airborne sites varies widely with a third of non-airborne fluids. Patients with bowel and non-specific symptoms have persistence of virus in feces for upto 2 weeks after symptom resolution. Although there was a very low detection rate in urine, given the more frequent prevalence in blood samples, the presence of SARS-CoV-2 in patients with disrupted urothelium or undergoing urinary tract procedures, is likely to be higher. Healthcare providers need to consider non-airborne transmission and persistence of SARS-CoV-2 in body fluids to enable appropriate precautions to protect healthcare workers and carers.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||
SWORD Depositor: | Library Publications Router | ||||
Journal or Publication Title: | Turkish Journal of Urology | ||||
Publisher: | Turkish Association of Urology | ||||
ISSN: | 2149-3235 | ||||
Official Date: | 1 March 2021 | ||||
Dates: |
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Volume: | 47 | ||||
Number: | 2 | ||||
Page Range: | pp. 87-97 | ||||
DOI: | 10.5152/tud.2021.20586 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Open Access (Creative Commons) |
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