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VIRAL SHEDDING OF SARS-COV-2 IN BODY FLUIDS ASSOCIATED WITH SEXUAL ACTIVITY: A SYSTEMATIC REVIEW AND META-ANALYSIS
Author
Calvet, Guilherme Amaral
Kara, Edna
Gonsalves, Lianne
Seuc, Armando Humberto
Oliveira, Raquel de Vasconcellos Carvalhaes de
Thwin, Soe Soe
León, Rodolfo Gomez Ponce de
Gámez, Maité Cabrera
Peña, Gilda Monteagudo
Pendás, Bertha Victoria Rodríguez
Alzugaray, Manuel Gómez
Carballo, Gisel Ovies
Cala, Duniesky Cintra
Guimarães, Patrícia Machado Quintaes
Bonet, Mercedes
Taylor, Melanie
Thorson, Anna
Kim, Caron
Ali, Moazzam
Broutet, Nathalie
Kara, Edna
Gonsalves, Lianne
Seuc, Armando Humberto
Oliveira, Raquel de Vasconcellos Carvalhaes de
Thwin, Soe Soe
León, Rodolfo Gomez Ponce de
Gámez, Maité Cabrera
Peña, Gilda Monteagudo
Pendás, Bertha Victoria Rodríguez
Alzugaray, Manuel Gómez
Carballo, Gisel Ovies
Cala, Duniesky Cintra
Guimarães, Patrícia Machado Quintaes
Bonet, Mercedes
Taylor, Melanie
Thorson, Anna
Kim, Caron
Ali, Moazzam
Broutet, Nathalie
Affilliation
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Doenças Febris Agudas. Rio de Janeiro, RJ, Brasil.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
National Institute of Hygiene Epidemiology and Microbiology. Habana, La Habana, Cuba.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Epidemiologia Clínica. Rio de Janeiro, RJ, Brasil.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
Latin American Center for Perinatology Women and Reproductive Health. Montevideo, Uruguay.
National Institute of Endocrinology and Metabolic Diseases. La Habana, Cuba.
National Institute of Endocrinology and Metabolic Diseases. La Habana, Cuba.
National Institute of Endocrinology and Metabolic Diseases. La Habana, Cuba.
National Institute of Endocrinology and Metabolic Diseases. La Habana, Cuba.
National Institute of Endocrinology and Metabolic Diseases. La Habana, Cuba.
Pan American Health Organization Cuba. La Habana, Cuba.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Doenças Febris Agudas. Rio de Janeiro, RJ, Brasil.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
Centers for Disease Control and Prevention. Atlanta, Georgia, USA.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
National Institute of Hygiene Epidemiology and Microbiology. Habana, La Habana, Cuba.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Epidemiologia Clínica. Rio de Janeiro, RJ, Brasil.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
Latin American Center for Perinatology Women and Reproductive Health. Montevideo, Uruguay.
National Institute of Endocrinology and Metabolic Diseases. La Habana, Cuba.
National Institute of Endocrinology and Metabolic Diseases. La Habana, Cuba.
National Institute of Endocrinology and Metabolic Diseases. La Habana, Cuba.
National Institute of Endocrinology and Metabolic Diseases. La Habana, Cuba.
National Institute of Endocrinology and Metabolic Diseases. La Habana, Cuba.
Pan American Health Organization Cuba. La Habana, Cuba.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Doenças Febris Agudas. Rio de Janeiro, RJ, Brasil.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
Centers for Disease Control and Prevention. Atlanta, Georgia, USA.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
World Health Organization. Department of Sexual and Reproductive Health and Research. Geneva, Switzerland.
Abstract
Objective: To identify and summarise the evidence on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection and persistence in body fluids associated with sexual activity (saliva, semen, vaginal secretion, urine and faeces/rectal secretion). Eligibility: All studies that reported detection of SARS-CoV-2 in saliva, semen, vaginal secretion, urine and faeces/rectal swabs. Information sources: The WHO COVID-19 database from inception to 20 April 2022. Risk of bias assessment: The National Institutes of Health tools. Synthesis of results: The proportion of patients with positive results for SARS-CoV-2 and the proportion of patients with a viral duration/persistence of at least 14 days in each fluid was calculated using fixed or random effects models. Included studies: A total of 182 studies with 10 023 participants. Results: The combined proportion of individuals with detection of SARS-CoV-2 was 82.6% (95% CI: 68.8% to 91.0%) in saliva, 1.6% (95% CI: 0.9% to 2.6%) in semen, 2.7% (95% CI: 1.8% to 4.0%) in vaginal secretion, 3.8% (95% CI: 1.9% to 7.6%) in urine and 31.8% (95% CI: 26.4% to 37.7%) in faeces/rectal swabs. The maximum viral persistence for faeces/rectal secretions was 210 days, followed by semen 121 days, saliva 112 days, urine 77 days and vaginal secretions 13 days. Culturable SARS-CoV-2 was positive for saliva and faeces. Limitations: Scarcity of longitudinal studies with follow-up until negative results. Interpretation: SARS-CoV-2 RNA was detected in all fluids associated with sexual activity but was rare in semen and vaginal secretions. Ongoing droplet precautions and awareness of the potential risk of contact with faecal matter/rectal mucosa are needed.
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