• Yu-Han Xing, Wei Ni, Qin Wu, Wen-Jie Li, Guo-Ju Li, Wen-Di Wang, Jian-Ning Tong, Xiu-Feng Song, Wing-Kin Wong Gary G Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: wingkinwong@cuhk.edu.hk., and Quan-Sheng Xing.
• Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
• J Microbiol Immunol Infect. 2020 Jun 1; 53 (3): 473-480.

ObjectiveTo determine the dynamic changes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in respiratory and fecal specimens in children with coronavirus disease 2019 (COVID-19).MethodsFrom January 17, 2020 to February 23, 2020, three paediatric cases of COVID-19 were reported in Qingdao, Shandong Province, China. Epidemiological, clinical, laboratory, and radiological characteristics and treatment data were collected. Patients were followed up to March 10, 2020, and dynamic profiles of nucleic acid testing results in throat swabs and fecal specimens were closely monitored.ResultsClearance of SARS-CoV-2 in respiratory tract occurred within two weeks after abatement of fever, whereas viral RNA remained detectable in stools of pediatric patients for longer than 4 weeks. Two children had fecal SARS-CoV-2 undetectable 20 days after throat swabs showing negative, while that of another child lagged behind for 8 days.ConclusionsSARS-CoV-2 may exist in children's gastrointestinal tract for a longer time than respiratory system. Persistent shedding of SARS-CoV-2 in stools of infected children raises the possibility that the virus might be transmitted through contaminated fomites. Massive efforts should be made at all levels to prevent spreading of the infection among children after reopening of kindergartens and schools.Copyright © 2020. Published by Elsevier B.V.

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