Your browser doesn't support javascript.
Gastrointestinal and hepatic manifestations of COVID-19: A systematic review and meta-analysis.
Dorrell, Robert D; Dougherty, Michael K; Barash, Eric L; Lichtig, Asher E; Clayton, Steven B; Jensen, Elizabeth T.
  • Dorrell RD; Department of Medicine Medical Center Blvd Winston-Salem North Carolina USA.
  • Dougherty MK; Division of Gastroenterology and Hepatology University of North Carolina at Chapel Hill Chapel Hill North Carolina USA.
  • Barash EL; Department of Wake Forest School of Medicine Medical Center Blvd Winston-Salem North Carolina USA.
  • Lichtig AE; Department of Wake Forest School of Medicine Medical Center Blvd Winston-Salem North Carolina USA.
  • Clayton SB; Department of Medicine, Section on Gastroenterology Medical Center Blvd Winston-Salem North Carolina USA.
  • Jensen ET; Department of Epidemiology and Prevention Medical Center Blvd Winston-Salem North Carolina USA.
JGH Open ; 5(1): 107-115, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-938473
ABSTRACT
Background and

Aim:

This review investigates the role of gastrointestinal and hepatic manifestations in COVID-19, particularly with regard to the prevalence of isolated gastrointestinal (GI) symptoms.

Methods:

We searched PubMed, Embase, and Cochrane library for COVID-19 publications from 1 December 2019 to 18 May 2020. We included any study that reported the presence of GI symptoms in a sample of >5 COVID-19 patients. Data collection and risk of bias assessment were performed independently by two reviewers. Where ≥3 studies reported data sufficiently similar to allow calculation of a pooled prevalence, we performed random effects meta-analysis.

Results:

This review included 17 776 COVID-19 patients from 108 studies. Isolated GI symptoms only occurred in 1% (95% confidence interval [CI] 0-6%) of patients. GI symptoms were reported in 20% (95% CI 15-24%) of patients. The most common were anorexia (21%, 95% CI 15-27%), diarrhea (13%, 95% CI 11-16%), nausea or vomiting (8%, 95% CI 6-11%), and abdominal pain (4%, 95% CI 2-6%). Transaminase elevations were present in 24% (95% CI 17-31%) of patients. Higher prevalence of GI symptoms were reported in studies published after 1st April, with prevalence of diarrhea 16% (95% CI 13-20), nausea or vomiting 12% (95% CI 8-16%), and any GI symptoms 24% (95% CI 18-34%). GI symptoms were associated with severe COVID-19 disease (odds ratio [OR] 2.1, 95% CI 1.3-3.2), but not mortality (OR 0.90, 95% CI 0.52-1.54).

Conclusions:

Patients with isolated GI symptoms may represent a small but significant portion of COVID-19 cases. When testing resources are abundant, clinicians should still consider testing patients with isolated GI symptoms or unexplained transaminase elevations for COVID-19. More recent studies estimate higher overall GI involvement in COVID-19 than was previously recognized.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Language: English Journal: JGH Open Year: 2021 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Language: English Journal: JGH Open Year: 2021 Document Type: Article