However, the characteristics of the VST in SARS-CoV-2 infections have not been well-clarified. The VST is an important parameter for judging hospital discharge, discontinuation of quarantine and the effect of antiviral treatment for infectious diseases, which mainly determines disease transmission and the duration of infectiousness ( 12). Persons infected with SARS-CoV-2 with long viral shedding times (VSTs) have drawn considerable concern, which put greater challenges and difficulties on epidemic prevention and control ( 8– 11). Diarrhea, loss of smell or taste, and other extra-pulmonary clinical manifestations can also be found in some patients ( 4– 7). Pulmonary clinical manifestations are the most common clinical presentations of COVID-19, such as fever, cough, shortness of breath, sputum production, respiratory failure and even acute respiratory distress syndrome (ARDS). As of February 4, 2021, more than 104 million cases of COVID-19 have been reported with over 2.2 million deaths globally ( 3). The first epidemic was Severe Acute Respiratory Syndrome (SARS) caused by SARS-CoV-1 in 2003, the second outbreak was Middle East Respiratory Syndrome (MERS) caused by MERS-CoV in 2012, and the third and most recent pandemic was Coronavirus Disease 2019 (COVID-19) caused by SARS-CoV-2 ( 1, 2). 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).Ĭonclusions: A longer VST was found in symptomatic infections, infected adults, persons with chronic diseases, and stool specimens.Ĭoronaviruses (CoVs), belonging to Nidovirales order, have caused three global outbreaks in the past 20 years. Results: A total of 35 studies involving 3,385 participants met the inclusion criteria. The VSTs in SARS-CoV-2 infections based on different demographic and clinical characteristics, treatments and specimens were stratified by subgroup analysis. Pooled estimates and 95% CIs for the VSTs were calculated using log-transformed data. 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. Here, we performed a meta-analysis to comprehensively summarize the VST of SARS-CoV-2. However, it was heterogeneous in the existing studies. State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, Chinaīackground: The viral shedding time (VST) of SARS-CoV-2 mainly determines its transmission and duration of infectiousness.Danying Yan †, Xiaobao Zhang †, Can Chen, Daixi Jiang, Xiaoxiao Liu, Yuqing Zhou, Chenyang Huang, Yiyi Zhou, Zhou Guan, Cheng Ding, Lu Chen, Lei Lan, Xiaofang Fu, Jie Wu *, Lanjuan Li * and Shigui Yang *
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