Copyright ©The Author(s) 2021.
World J Clin Cases. Oct 6, 2021; 9(28): 8280-8294
Published online Oct 6, 2021. doi: 10.12998/wjcc.v9.i28.8280
Table 1 Main gastrointestinal manifestations in the articles discussed in the text
Any GI symptom
Abdominal pain
Loss of appetite
Redd et al[35]1951078446110
Lin et al[36]582317ND17
Pan et al[38]103354281
Jin et al[40]7453NDNDND
Sulaiman et al[41]7841324240
Table 2 Detection of severe acute respiratory syndrome by coronavirus 2 RNA in anal swabs or fecal sample


nRef.CountrynAgeRT-PCRStoolPSDIRespiratoryPRDIRelevance information
1Xie et al[56] China44-9 yrAS-PS4/48-33 d4/411-21 dOne patient with positive stool RNA 54 d after hospital admission
2Ge et al[57] China155 yrFS-RS1/118 d1/17 dPositive stool RNA 22 d after negative respiratory
3Lo et al[58] China1027-64 yrFS-PS10/105-19 d10/109-24 dSome patients had positive stool even with negative respiratory
4Zhang et al[17] China36-9 yrAS-PS3/316-20 d3/37-14 dThe anal swab was positive after 10 d of discharge
5Liu et al[59] China9NRAS-PS8/928-66 d9/96–24 dPositive stool RNA 46 d after discharge
6Wang et al[60] China535-56 yrFS-PS5/511-30 d5/55-9 dEven after a negative respiratory test, IgM was positive on 2 consecutive occasions
7Wang X et al[61] China324-42 yrFS-PS2/330-36 d3/315-29 d-
8Xing et al[62] China3NDFS-PS3/38 d-4 wk3/32 wkPositive stool RNA 8-20 d after negative respiratory
9Chen et al[63] China4242-62 yrAS-FS28/421-24 d42/421-19 dEighteen patients remained positive for viral RNA in the feces after the pharyngeal swabs turned negative
10Wu et al[64] China74NDFS-PS33/7427, 9 d74/7416, 7 dFecal positive 47 d after the onset of the first symptoms
11Li et al[65] China1333-73 yrFS-RS5/13Until 38 d13/135-14 dPositive stool RNA 14-15 d after negative respiratory
12Du et al[66] China109 mo-14 yrFS-PS7/10Mean 34.43 d10/10Mean 9 dSeven patients positive stool RNA 2 wk after discharge but negative respiratory and urine
13Xiao et al[16] China7310 mo-78 yrFS-PS39/731-12 dNDNDSeventeen patients positive stool RNA after negative respiratory
14Xu et al[67] China102 mo-15 yrAS-PS8/101-27 d10/101-21Eight patients positive stool RNA after negative respiratory
15Fan et al[68] China13 moAS-PS1/11-28 d1/11-14Positive stool RNA 14 d after negative respiratory
Table 3 Detection of severe acute respiratory syndrome by coronavirus 2 RNA in water systems
Wastewater type
Main findings
Medema et al[96] The NetherlandsSewageSewage samples of six cities and the airport were tested: (1) February: No SARS-CoV-2 RNA was detected; and (2) March: SARS-CoV-2 RNA detection increased concomitant with the increase in COVID-19 prevalence
Ahmed et al[97] AustraliaWastewater in a catchmentTwo positive detections within a 6-d period from the same wastewater treatment plant
Kumar et al[98] IndiaWastewater Treatment PlantIncrease in SARS-CoV-2 RNA samples was concomitant with the increase in the number of active COVID-19 patients in the city
Wurtzer et al[99] FranceWastewater treatment plant (raw and treated wastewater samples)Raw wastewater samples: all positive for SARS-CoV2; Treated wastewater samples: 6 out of 8 positive for SARS-CoV2
Randazzo et al[100] SpainWastewater treatments plants(1) Influent samples: 35 of 42 were positive for SARS-CoV-2; (2) Effluent secondary treated samples: 2 of 18 were tested positive; and (3) Effluent tertiary treated samples: 0 of 12 tested positive
Kocamemi et al[101] TurkeyWastewater treatment plants (primary sludge and waste activated sludge)SARS-CoV-2 RNA was detected quantitatively from all samples.
Guerrero-Latorre et al[102] EcuadorRiverSARS-CoV-2 RNA was detected in the three locations
Zhang et al[103] ChinaSeptic tanksSARS-CoV-2 RNA was detected in septic tanks after disinfection with sodium hypochlorite
Ahmed et al[104] United StatesWastewater treatment plantsTwo out of 15 wastewater samples tested positive
Haramoto et al[105] JapanRiver, wastewater treatment plantsOne of 5 secondary-treated wastewater samples tested positive
La Rosa et al[106] ItalySewageSix out of 12 samples tested positive.
Hasan et al[107] United Arab EmiratesSewage, wastewater treatment plants, pumping stationsSARS-CoV-2 RNA was detected in 85% of untreated wastewater samples; SARS-CoV-2 RNA was not detected in wastewater treatment plants.