Gastrointestinal symptoms in patients with mild and severe COVID-19: a scoping review and meta-analysis
Gastroenterology and Hepatology from Bed to Bench,
20 September 2020
Aim: The current research aimed to analyze and summarize observational studies that compared the incidence of gastrointestinal symptoms in mild and severe COVID-19 infection.
Background: Coronavirus disease 2019 (COVID-19) has been identified as public health throat worldwide. However, previous studies have reported contradictory results of COVID-19-related gastrointestinal symptoms in severe and mild forms.
Methods: Databases were searched using Medline, ISI Web of Science, EMBASE, and Cochrane Library up to May 2020. Data from each study were combined using the random-effects model, to calculate Odds Ratio (ORs) and 95% confidence intervals (95% CIs). Sensitivity analysis was examined by sequentially excluding one study in each turn. Publication bias was evaluated using the Egger’s and Begg’s tests.
Results: Totally 20 studies were included (4,265 patients). We found that the prevalence of diarrhea [OR (0.40), (95% CI 0.91, -2.16), P= 0.03, I2 = 88.1%, PHeterogenity= 0.00)] and nausea & vomiting [OR (0.27), (95% CI 0.07, 1.01), P= 0.05, I2 = 89.3%, PHeterogenity= 0.00)] significantly increased in severe COVID-19 compared to mild form, while, abdominal pain and anorexia had no significant increased prevalence in admitted and hospitalized patients with COVID-19. Moreover, COVID-19-related gastrointestinal symptoms were higher in males [OR (1.42), (95% CI 1.23, 1.65), P<0.05, I2= 18.4%, PHeterogenity= 0.23] than females. No significant publication bias was observed in the meta-analysis. Sensitivity analyses showed a similar effect size while reducing the heterogeneity.
Conclusion: Our data provide valuable information for the discovery of prognosis biomarkers to diagnosis more severe disease in the early stages of COVID-19.
- Gastrointestinal symptoms
- Digestive symptoms
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