Characteristics of Viral Shedding Time in SARS-CoV-2 Infections: A Systematic Review and Meta-Analysis
Danying Yan, Xiaobao Zhang, Can Chen, Daixi Jiang, Xiaoxiao Liu, Yuqing Zhou, Chenyang Huang, Yiyi Zhou, Zhou Guan, Cheng Ding, Lü Chen, Lei Lan, Xiaofang Fu, Jie Wu, Lanjuan Li, Shigui Yang
Abstract
Background: The viral shedding time (VST) of SARS-CoV-2 mainly determines its transmission and duration of infectiousness. However, it was heterogeneous in the existing studies. Here, we performed a meta-analysis to comprehensively summarize the VST of SARS-CoV-2. Methods: We searched PubMed, Web of Science, MedRxiv, BioRxiv, CNKI, CSTJ, and Wanfang up to October 25, 2020, for studies that reported VSTs of SARS-CoV-2. Pooled estimates and 95% CIs for the VSTs were calculated using log-transformed data. The VSTs in SARS-CoV-2 infections based on different demographic and clinical characteristics, treatments and specimens were stratified by subgroup analysis. Results: A total of 35 studies involving 3,385 participants met the inclusion criteria. The pooled mean VST was 16.8 days (95% CI: 14.8–19.4, I 2 = 99.56%) in SARS-CoV-2 infections. The VST was significantly longer in symptomatic infections (19.7 days, 95% CI: 17.2–22.7, I 2 = 99.34%) than in asymptomatic infections (10.9 days, 95% CI: 8.3–14.3, I 2 = 98.89%) ( P < 0.05). The VST was 23.2 days (95% CI: 19.0–28.4, I 2 = 99.24%) in adults, which was significantly longer than that in children (9.9 days, 95% CI: 8.1–12.2, I 2 = 85.74%) ( P < 0.05). The VST was significantly longer in persons with chronic diseases (24.2 days, 95% CI: 19.2–30.2, I 2 = 84.07%) than in those without chronic diseases (11.5 days, 95% CI: 5.3–25.0, I 2 = 82.11%) ( P < 0.05). Persons receiving corticosteroid treatment (28.3 days, 95% CI: 25.6–31.2, I 2 = 0.00%) had a longer VST than those without corticosteroid treatment (16.2 days, 95% CI: 11.5–22.5, I 2 = 92.27%) ( P = 0.06). The VST was significantly longer in stool specimens (30.3 days, 95% CI: 23.1–39.2, I 2 = 92.09%) than in respiratory tract specimens (17.5 days, 95% CI: 14.9–20.6, I 2 = 99.67%) ( P < 0.05). Conclusions: A longer VST was found in symptomatic infections, infected adults, persons with chronic diseases, and stool specimens.