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Prevalence and Mortality of COVID-19 Patients With Gastrointestinal Symptoms: A Systematic Review and Meta-analysis.
Mayo Clin Proc. 2020 08; 95(8):1632-1648.MC

Abstract

OBJECTIVE

To perform a systematic review and meta-analysis evaluating the prevalence of gastrointestinal (GI) symptoms and mortality in patients with coronavirus disease 2019 (COVID-19) diagnosed.

METHODS

A systematic search of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus was performed from December 1, 2019 to May 7, 2020. Observational studies including adults with COVID-19 infection and reporting GI symptoms were included. The primary outcome was assessing the weighted pooled prevalence (WPP) of GI symptoms in patients with COVID-19 infection. Secondary outcomes were WPP of overall mortality, and mortality in patients with COVID-19 infection with GI symptoms.

RESULTS

A total of 78 studies with 12,797 patients were included. Among GI symptoms (at onset of illness in 6, at admission in 17, data given separately for both in 3, and data unavailable in 52 studies), the WPP of diarrhea was 12.4% (95% CI, 8.2% to 17.1%), I2=94%; nausea and/or vomiting, 9.0% (95% CI, 5.5% to 12.9%), I2=93%; loss of appetite, 22.3% (95% CI, 11.2% to 34.6%, I2=94%; and abdominal pain, 6.2% (95% CI, 2.6% to 10.3%), I2=92%. Mortality among patients with GI symptoms (0.4%; 95% CI, 0% to 1.1%; I2=74%) was similar to overall mortality (2.1%; 95% CI, 0.2% to 4.7%; I2=94%), P=.15. Most studies had high risk of bias and overall quality of evidence was low to very low for all outcomes.

CONCLUSION

Gastrointestinal symptoms are seen in up to 1 in 5 patients with COVID-19 infection. More high-quality evidence is needed to confirm these findings and explore factors causing mortality in these patients.

Links

PMC Free PDF

Authors+Show Affiliations

Tariq R
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN; Department of Internal Medicine, Rochester General Hospital, Rochester, NY.
Saha S
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
Furqan F
Department of Internal Medicine, Rochester General Hospital, Rochester, NY.
Hassett L
Mayo Clinic Libraries, Mayo Clinic, Rochester, MN.
Pardi D
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
Khanna S
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN. Electronic address: khanna.sahil@mayo.edu.

MeSH

AdultBetacoronavirusCOVID-19Coronavirus InfectionsGastrointestinal DiseasesGlobal HealthHumansPandemicsPneumonia, ViralSARS-CoV-2

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32753138

Clinical Trial Links

Efficacy of Probiotics in the Treatment of Hospitalised Patients With Novel Coronavirus Infection

Citation

Tariq, Raseen, et al. "Prevalence and Mortality of COVID-19 Patients With Gastrointestinal Symptoms: a Systematic Review and Meta-analysis." Mayo Clinic Proceedings, vol. 95, no. 8, 2020, pp. 1632-1648.
Tariq R, Saha S, Furqan F, et al. Prevalence and Mortality of COVID-19 Patients With Gastrointestinal Symptoms: A Systematic Review and Meta-analysis. Mayo Clin Proc. 2020;95(8):1632-1648.
Tariq, R., Saha, S., Furqan, F., Hassett, L., Pardi, D., & Khanna, S. (2020). Prevalence and Mortality of COVID-19 Patients With Gastrointestinal Symptoms: A Systematic Review and Meta-analysis. Mayo Clinic Proceedings, 95(8), 1632-1648. https://doi.org/10.1016/j.mayocp.2020.06.003
Tariq R, et al. Prevalence and Mortality of COVID-19 Patients With Gastrointestinal Symptoms: a Systematic Review and Meta-analysis. Mayo Clin Proc. 2020;95(8):1632-1648. PubMed PMID: 32753138.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and Mortality of COVID-19 Patients With Gastrointestinal Symptoms: A Systematic Review and Meta-analysis. AU - Tariq,Raseen, AU - Saha,Srishti, AU - Furqan,Fateeha, AU - Hassett,Leslie, AU - Pardi,Darrell, AU - Khanna,Sahil, Y1 - 2020/06/10/ PY - 2020/04/17/received PY - 2020/05/29/revised PY - 2020/06/02/accepted PY - 2020/8/6/entrez PY - 2020/8/6/pubmed PY - 2020/8/15/medline SP - 1632 EP - 1648 JF - Mayo Clinic proceedings JO - Mayo Clin Proc VL - 95 IS - 8 N2 - OBJECTIVE: To perform a systematic review and meta-analysis evaluating the prevalence of gastrointestinal (GI) symptoms and mortality in patients with coronavirus disease 2019 (COVID-19) diagnosed. METHODS: A systematic search of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus was performed from December 1, 2019 to May 7, 2020. Observational studies including adults with COVID-19 infection and reporting GI symptoms were included. The primary outcome was assessing the weighted pooled prevalence (WPP) of GI symptoms in patients with COVID-19 infection. Secondary outcomes were WPP of overall mortality, and mortality in patients with COVID-19 infection with GI symptoms. RESULTS: A total of 78 studies with 12,797 patients were included. Among GI symptoms (at onset of illness in 6, at admission in 17, data given separately for both in 3, and data unavailable in 52 studies), the WPP of diarrhea was 12.4% (95% CI, 8.2% to 17.1%), I2=94%; nausea and/or vomiting, 9.0% (95% CI, 5.5% to 12.9%), I2=93%; loss of appetite, 22.3% (95% CI, 11.2% to 34.6%, I2=94%; and abdominal pain, 6.2% (95% CI, 2.6% to 10.3%), I2=92%. Mortality among patients with GI symptoms (0.4%; 95% CI, 0% to 1.1%; I2=74%) was similar to overall mortality (2.1%; 95% CI, 0.2% to 4.7%; I2=94%), P=.15. Most studies had high risk of bias and overall quality of evidence was low to very low for all outcomes. CONCLUSION: Gastrointestinal symptoms are seen in up to 1 in 5 patients with COVID-19 infection. More high-quality evidence is needed to confirm these findings and explore factors causing mortality in these patients. SN - 1942-5546 UR - https://www.unboundmedicine.com/medline/citation/32753138/Prevalence_and_Mortality_of_COVID_19_Patients_With_Gastrointestinal_Symptoms:_A_Systematic_Review_and_Meta_analysis_ DB - PRIME DP - Unbound Medicine ER -