It is not uncommon for patients with new coronavirus pneumonia to test positive for anal swab nucleic acid, but in children, the positive can last more than seven weeks.
On March 13, the clinical research team of Guangzhou Women's and Children's Medical Center published a research article "Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding" in the academic journal "Nature Medicine".
The article summarizes and analyzes the epidemiological and clinical characteristics of 10 confirmed children admitted to the Guangzhou Women and Children Medical Center in the early stage of the outbreak of the new coronavirus pneumonia.
You can find the article here:ย https://www.nature.com/articles/s41591-020-0817-4
The study found that the possibility of new coronavirus transmission in feces through the feces in children's cases, as well as the long-term existence of positive anal swab nucleic acid test and long intestinal detoxification. The findings provide clinical diagnosis and treatment of children infected with the new coronavirus This important reference provides new ideas and directions for the diagnosis, treatment and rehabilitation observation of children's cases.
The research data was shared with the World Health Organization when it was published.
In the new coronavirus pneumonia epidemic, Guangzhou Women's and Children's Medical Center, as the designated hospital for children's cases in Guangzhou, has treated the first confirmed case of children in Guangzhou since January 22, and has so far admitted 10 confirmed children.
In clinical diagnosis and treatment, the hospital found that these children presented three major clinical characteristics:
Anal swabs have a long positive nucleic acid test and a long bowel detoxification time;
In the case of asymptomatic infection, CT is better than X-ray examination to detect signs of pneumonia;
Most cases of children are cluster-onset in the family, and the symptoms are mild, common and even asymptomatic infection.
Of the 10 confirmed cases, 6 were male and 4 were female, ranging in age from 2 months to 15 years.
The research paper pointed out that after the throat swabs became negative, the anal swab test results of 8 children were still positive, increasing the possibility of fecal-oral transmission.
"From clinical statistical observations, the detoxification time of children with throat swabs was more than two weeks, and most of them turned negative in three to five days, but the positive test of anal swabs lasted longer, and the longest case was found. , Can be more than 7 weeks. "Xu Yi, director of the infection department of Guangzhou Women and Children's Medical Center, told Yicai.com.
The longest child with positive anal swabs mentioned by Xu Yi turned negative after 51 days, and is still under medical observation 14 days after discharge.
The above research paper also pointed out that anal swab detection may be more useful than a throat swab in judging the effect of treatment, but it has not been found whether the anal swab virus has the ability to replicate, and this is exactly what confirms the potential of fecal-oral transmission Required evidence.
Gong Sitang, deputy director of Guangzhou Women's and Children's Medical Center, told Yicai.com that anal swabs are positive for nucleic acid test, and they are positive for throat swabs. The diagnostic value is the same, which confirms the infection status.
As for whether the former has the same spread and how strong the spread is, it is still unknown, and further research is needed, which is also the direction of the hospital's next focus.
Previously, in order to reduce the source of infection to a minimum, Guangzhou Women's and Children's Medical Center has harmlessly treated feces excreted by children and diapers of small infants.
It is worth noting that the children diagnosed above are mostly asymptomatic, light or common, but the anal swab nucleic acid test is positive for a long time. How does the mechanism behind this happen? The above paper has not yet been elaborated.
In response to this clinical phenomenon, Gong Sitang also told Yicai.com that it has now risen to scientific research and believes that there will be an answer soon.
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