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Novelty in the gut: a systematic review and meta-analysis of the gastrointestinal manifestations of COVID-19.
BMJ Open Gastroenterol. 2020 05; 7(1)BO

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.

Authors+Show Affiliations

Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA drvishnucharan@gmail.com.Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.Department of General Medicine, Sri Ramaswamy Memorial Group of Educational Institutions, Chennai, Tamil Nadu, India.Department of Internal Medicine, Trumbull Regional Medical Center, Warren, Ohio, USA.Division of Gastroenterology, Syracuse VA Medical Center, Syracuse, New York, USA. Division of Gastroenterology, SUNY Upstate Medical University, Syracuse, New York, USA.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32457035

Citation

Suresh Kumar, Vishnu Charan, et al. "Novelty in the Gut: a Systematic Review and Meta-analysis of the Gastrointestinal Manifestations of COVID-19." BMJ Open Gastroenterology, vol. 7, no. 1, 2020.
Suresh Kumar VC, Mukherjee S, Harne PS, et al. Novelty in the gut: a systematic review and meta-analysis of the gastrointestinal manifestations of COVID-19. BMJ Open Gastroenterol. 2020;7(1).
Suresh Kumar, V. C., Mukherjee, S., Harne, P. S., Subedi, A., Ganapathy, M. K., Patthipati, V. S., & Sapkota, B. (2020). Novelty in the gut: a systematic review and meta-analysis of the gastrointestinal manifestations of COVID-19. BMJ Open Gastroenterology, 7(1). https://doi.org/10.1136/bmjgast-2020-000417
Suresh Kumar VC, et al. Novelty in the Gut: a Systematic Review and Meta-analysis of the Gastrointestinal Manifestations of COVID-19. BMJ Open Gastroenterol. 2020;7(1) PubMed PMID: 32457035.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Novelty in the gut: a systematic review and meta-analysis of the gastrointestinal manifestations of COVID-19. AU - Suresh Kumar,Vishnu Charan, AU - Mukherjee,Samiran, AU - Harne,Prateek Suresh, AU - Subedi,Abinash, AU - Ganapathy,Muthu Kuzhali, AU - Patthipati,Venkata Suresh, AU - Sapkota,Bishnu, PY - 2020/04/08/received PY - 2020/05/04/revised PY - 2020/05/06/accepted PY - 2020/5/28/entrez PY - 2020/5/28/pubmed PY - 2020/6/3/medline KW - abdominal pain KW - diarrhoea KW - epidemiology KW - gastrointestinal pathology KW - infectious diarrhoea JF - BMJ open gastroenterology JO - BMJ Open Gastroenterol VL - 7 IS - 1 N2 - 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. SN - 2054-4774 UR - https://www.unboundmedicine.com/medline/citation/32457035/Novelty_in_the_gut:_a_systematic_review_and_meta_analysis_of_the_gastrointestinal_manifestations_of_COVID_19_ L2 - https://bmjopengastro.bmj.com/lookup/pmidlookup?view=long&pmid=32457035 DB - PRIME DP - Unbound Medicine ER -