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Novelty in the gut: a systematic review and meta-analysis of the gastrointestinal manifestations of COVID-19.
Suresh Kumar, Vishnu Charan; Mukherjee, Samiran; Harne, Prateek Suresh; Subedi, Abinash; Ganapathy, Muthu Kuzhali; Patthipati, Venkata Suresh; Sapkota, Bishnu.
  • Suresh Kumar VC; Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA drvishnucharan@gmail.com.
  • Mukherjee S; Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
  • Harne PS; Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
  • Subedi A; Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
  • Ganapathy MK; Department of General Medicine, Sri Ramaswamy Memorial Group of Educational Institutions, Chennai, Tamil Nadu, India.
  • Patthipati VS; Department of Internal Medicine, Trumbull Regional Medical Center, Warren, Ohio, USA.
  • Sapkota B; Division of Gastroenterology, Syracuse VA Medical Center, Syracuse, New York, USA.
BMJ Open Gastroenterol ; 7(1)2020 05.
Article in English | MEDLINE | ID: covidwho-413074
ABSTRACT

BACKGROUND:

The COVID-19 epidemic has affected over 2.6 million people across 210 countries. Recent studies have shown that patients with COVID-19 experience relevant gastrointestinal (GI) symptoms. We aimed to perform a systematic review and meta-analysis on the GI symptoms of COVID-19.

METHODS:

A literature search was conducted via electronic databases, including PubMed, Embase, Scopus, and Google Scholar, from inception until 20 March 2020. Data were extracted from relevant studies. A systematic review of GI symptoms and a meta-analysis comparing symptoms in severe and non-severe patients was performed using RevMan V.5.3.

RESULTS:

Pooled data from 2477 patients with a reverse transcription-PCR-positive COVID-19 infection across 17 studies were analysed. Our study revealed that diarrhoea (7.8%) followed by nausea and/or vomiting (5.5 %) were the most common GI symptoms. We performed a meta-analysis comparing the odds of having GI symptoms in severe versus non-severe COVID-19-positive patients. 4 studies for nausea and/or vomiting, 5 studies for diarrhoea and 3 studies for abdominal pain were used for the analyses. There was no significant difference in the incidence of diarrhoea (OR=1.32, 95% CI 0.8 to 2.18, Z=1.07, p=0.28, I2=17%) or nausea and/or vomiting (OR=0.96, 95% CI 0.42 to 2.19, Z=0.10, p=0.92, I2=55%) between either group. However, there was seven times higher odds of having abdominal pain in patients with severe illness when compared with non-severe patients (OR=7.17, 95% CI 1.95 to 26.34, Z=2.97, p=0.003, I2=0%).

CONCLUSION:

Our study has reiterated that GI symptoms are an important clinical feature of COVID-19. Patients with severe disease are more likely to have abdominal pain as compared with patients with non-severe disease.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Betacoronavirus / Gastrointestinal Diseases Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Language: English Year: 2020 Document Type: Article Affiliation country: Bmjgast-2020-000417

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Betacoronavirus / Gastrointestinal Diseases Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Language: English Year: 2020 Document Type: Article Affiliation country: Bmjgast-2020-000417