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Meta-Analysis
. 2021 Aug 9;11(1):16131.
doi: 10.1038/s41598-021-95329-4.

Detection of three pandemic causing coronaviruses from non-respiratory samples: systematic review and meta-analysis

Chandan Mishra  1 , Suneeta Meena  2 , Jitendra Kumar Meena  3 , Suman Tiwari  4 , Purva Mathur  5
Affiliations
Meta-Analysis

Detection of three pandemic causing coronaviruses from non-respiratory samples: systematic review and meta-analysis

Chandan Mishra et al. Sci Rep. .

Abstract

SARS-CoV-2 has posed an unprecedented challenge to the world. Pandemics have been caused previously by viruses of this family like Middle East Respiratory Corona Virus (MERS CoV), Severe Acute Respiratory Syndrome Corona Virus (SARS CoV). Although these viruses are primarily respiratory viruses, but they have been isolated from non-respiratory samples as well. Presently, the detection rate of SARS-CoV-2 RNA from different clinical specimens using Real Time Reverse Transcriptase Polymerized Chain Reaction (qRT-PCR) after onset of symptoms is not yet well established. Therefore, the aim of this systematic review was to establish the profile of detecting SARS-CoV-2, MERS CoV, SARS CoV from different types of clinical specimens other than the respiratory using a standard diagnostic test (qRT-PCR). A total of 3429 non-respiratory specimens were recorded: SARS CoV (total sample-802), MERS CoV (total sample-155), SARS CoV-2 (total sample-2347). Out of all the samples studied high positive rate was seen for saliva with 96.7% (14/14; 95% CI 87.6-100.0%) for SARS CoV and 57.5% (58/250; 95% CI - 1.2 to 116.2%) for SARS CoV-2, while low detection rate in urine samples for SARS CoV-2 with 2.2% (8/318; 95% CI 0.6-3.7%) and 9.6% (12/61; 95% CI - 0.9 to 20.1%) for SARS CoV but there was relatively higher positivity in urine samples for MERS CoV with detection rate of 32.4% (2/38; 95% CI - 37.3 to 102.1%). In Stool sample positivity was 54.9% (396/779; 95% CI 41.0-68.8%), 45.2% (180/430; 95% CI 28.1-62.3%) and 34.7% (4/38; 95% CI - 29.5 to 98.9%) for SARS CoV-2, MERS CoV, and SARS CoV, respectively. In blood sample the positivity was 33.3% (7/21; 95% CI 13.2-53.5%), 23.7% (42/277; 95% CI 10.5-36.9%) and 2.5% (2/81; 95% CI 0.00-5.8%) for MERS CoV, SARS CoV-2 and SARS CoV respectively. SARS-CoV-2 along with previous two pandemic causing viruses from this family, were highly detected stool and saliva. A low positive rate was recorded in blood samples. Viruses were also detected in fluids along with unusual samples like semen and vaginal secretions thus highlighting unique pathogenic potential of SARS-CoV-2.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow chart showing study screening.
Figure 2
Figure 2
Forest plot of Sub group analysis for Heterogeneity in the analysed studies using Cochrane Q-statistic test and I2 statistic on different types of clinical specimens.
Figure 3
Figure 3
(a) Sensitivity analysis (leave one out) forest plot for COVID. (b) Sensitivity analysis (leave one out) forest plot for SARS and MERS.
Figure 3
Figure 3
(a) Sensitivity analysis (leave one out) forest plot for COVID. (b) Sensitivity analysis (leave one out) forest plot for SARS and MERS.
Figure 4
Figure 4
Risk of Bias assessment of included studies using QUADAS 2 tool displayed (traffic light plot) with bias summary (non-weighted).
Figure 5
Figure 5
Funnel plot based on egger bias.
See this image and copyright information in PMC

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