TY - JOUR T1 - Spatial and temporal dynamics of SARS-CoV-2 in COVID-19 patients: A systematic review and meta-analysis. AU - Weiss,Anne, AU - Jellingsø,Mads, AU - Sommer,Morten Otto Alexander, Y1 - 2020/07/22/ PY - 2020/05/28/received PY - 2020/07/02/revised PY - 2020/07/10/accepted PY - 2020/7/28/pubmed PY - 2020/9/4/medline PY - 2020/7/26/entrez KW - COVID-19 KW - SARS-CoV-2 KW - Systematic review KW - Viral dynamics SP - 102916 EP - 102916 JF - EBioMedicine JO - EBioMedicine VL - 58 N2 - BACKGROUND: The spatial and temporal dynamics of SARS-CoV-2 have been described in case series and retrospective studies. In this study, we provide a coherent overview of the duration of viral detection and viral RNA load in COVID-19 patients, stratified by specimen type, clinical severity, and age. METHOD: We systematically searched PubMed/MEDLINE and Cochrane review database for studies published between 1.11.2019 and 23.04.2020. We pooled the data of selected studies (22/7226 (650 patients) for meta-analysis) to estimate duration of viral detection and visualized viral load over time. FINDINGS: Our analysis showed consistent viral detection from specimen from the upper respiratory tract (URT), the lower respiratory tract (LRT), and faeces, irrespective of the clinical severity of COVID-19. Our analysis suggests that SARS-CoV-2 persists for a longer duration in the LRT compared to the URT in adult patients (5•7 days in mild; 5•9 days in moderate-severe patients). The differences in the duration of viral detection between mild and moderate-severe patients is limited in the LRT, but an indication of longer duration of viral detection for moderate-severe patients was observed in feces (15 days in mild vs. 21 days in moderate-severe patients) and the URT (12 days in mild vs. 16 days in moderate-severe patients). Further, viral load was demonstrated to peak in earlier stages of infection in the URT compared to LRT. INTERPRETATION: This review may aid mathematical modelling and help in defining appropriate endpoints for clinical trails with antivirals in COVID-19. FUNDING: The project has received funding support from Innovation Fund Denmark. SN - 2352-3964 UR - https://www.unboundmedicine.com/medline/citation/32711256/Spatial_and_temporal_dynamics_of_SARS_CoV_2_in_COVID_19_patients:_A_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2352-3964(20)30291-7 DB - PRIME DP - Unbound Medicine ER -