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Digestive symptoms and liver injury in patients with coronavirus disease 2019 (COVID-19): A systematic review with meta-analysis.
Wan, Jian; Wang, Xuan; Su, Song; Zhang, Yujie; Jin, Yirong; Shi, Yanting; Wu, Kaichun; Liang, Jie.
  • Wan J; State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi Province China.
  • Wang X; Department of Neurology, Xijing Hospital Fourth Military Medical University Xi'an Shaanxi Province China.
  • Su S; State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi Province China.
  • Zhang Y; State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi Province China.
  • Jin Y; State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi Province China.
  • Shi Y; State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi Province China.
  • Wu K; State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi Province China.
  • Liang J; State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi Province China.
JGH Open ; 4(6): 1047-1058, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-893233
Semantic information from SemMedBD (by NLM)
1. Digestive symptom PROCESS_OF Patients
Subject
Digestive symptom
Predicate
PROCESS_OF
Object
Patients
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Signs and Symptom PROCESS_OF C0030705
Subject
Signs and Symptom
Predicate
PROCESS_OF
Object
C0030705
4. Fatigue PROCESS_OF Patients
Subject
Fatigue
Predicate
PROCESS_OF
Object
Patients
5. Diarrhea PROCESS_OF Patients
Subject
Diarrhea
Predicate
PROCESS_OF
Object
Patients
6. Critical Illness PROCESS_OF Patients
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Patients
7. Digestive symptom PROCESS_OF Patients
Subject
Digestive symptom
Predicate
PROCESS_OF
Object
Patients
8. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
9. Signs and Symptoms, Respiratory PROCESS_OF Patients
Subject
Signs and Symptoms, Respiratory
Predicate
PROCESS_OF
Object
Patients
10. Fatigue PROCESS_OF Patients
Subject
Fatigue
Predicate
PROCESS_OF
Object
Patients
11. Diarrhea PROCESS_OF Patients
Subject
Diarrhea
Predicate
PROCESS_OF
Object
Patients
12. Critical Illness PROCESS_OF Patients
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Patients
ABSTRACT
Although most COVID-19 patients typically present with respiratory symptoms, many patients could experience digestive symptoms as the major complaint. We performed a systematic review and meta-analysis to investigate the exact prevalence of digestive symptoms and liver injury in COVID-19 patients and compare the difference between patients with and without digestive symptoms. PubMed, Embase, Ovid, Wanfang data, and CNKI were searched until 24 April 2020 to identify studies that reported digestive symptoms and liver injury in COVID-19 patients. A random-effect model was used to combine the data. Finally, 64 studies with 15 141 patients were included. The pooled rate of digestive symptoms and liver dysfunction was 31.8% (95 CI 21.0-42.5%, I 2 = 97.6%) and 27.4% (95 CI 16.9-37.9%, I 2 = 97.9%), respectively. Patients with digestive symptoms were more likely to present with fatigue (OR 2.28, 95 CI 1.66-3.14, P < 0.00001, I 2 = 31%), myalgia (OR 1.96, 95 CI 1.06-3.65, P = 0.03, I 2 = 69%), and acute respiratory disease syndrome (ARDS) (OR 2.94, 95 CI 1.17-7.40, P = 0.02, I 2 = 0) and had a trend to present as severe/critical type (OR 1.87, 95 CI 0.98-3.57, P = 0.06, I 2 = 58%). Severe/critical patients were more likely to present with diarrhea (OR 2.02, 95 CI 1.16-3.50, P = 0.01, I 2 = 64) and have high alanine aminotransferase (ALT) (OR 2.08, 95 CI 1.55-2.81, P < 0.00001, I 2 = 13%,) and aspartate aminotransferase (AST) (OR 3.53, 95 CI 2.76-4.51, P < 0.00001, I 2 = 0). The pooled rate of patients with digestive symptoms was 28.7% (95 CI 17.6-39.8%) and 42.8% (95 CI 23.4-62.3%) in studies from China and out of China, respectively. COVID-19 patients had a high rate of digestive symptoms and liver injury. Patients with digestive symptoms had a trend to develop severe/critical illness.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Language: English Journal: JGH Open Year: 2020

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Language: English Journal: JGH Open Year: 2020
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