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Gastrointestinal Manifestations of the Covid-19: A Systematic Review and Meta-Analysis With 111 Studies



Soltani S1, 2 ; Zakeri A3 ; Pakzad I4 ; Tabibzadeh A5 ; Zakeri AM6 ; Zandi M1, 2 ; Rezayat SA7 ; Jafarzadeh M8 ; Asl PK9 ; Zebardast A1 ; Erfani Y10 ; Shahbahrami R2 ; Pakzad R11, 12 ; Malekifar P13
Authors
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Authors Affiliations
  1. 1. Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
  4. 4. Department of Microbiology, School of Medicine, Ilam University Medical Sciences, Ilam, Iran
  5. 5. Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  6. 6. Pediatric Surgery Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  7. 7. Department of Health Care Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Endocrine research center, Institute of Endocrinology and Metabolism, Iran University of Medical Science, Tehran, Iran
  9. 9. Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Golestan, Iran
  10. 10. Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University Medical Sciences, Tehran, Iran
  11. 11. Department of Epidemiology, Faculty of Health, Ilam University Medical Sciences, Ilam, Iran
  12. 12. Health and Environment Research Center, Ilam University of Medical Sciences, Ilam, Iran
  13. 13. Department of Epidemiology, School of Public Health, Tehran University Medical Sciences, Tehran, Iran

Source: Journal of Biostatistics and Epidemiology Published:2021

Abstract

Introduction: Since the start of a pandemic from Wuhan, China in 2019, there is tremendous attention on the COVID-19 manifestation. One of the most important COVID-19 clinical presentations is gastrointestinal symptoms. The current systematic review study aims to focus on the implication of the gastrointestinal tract in patients infected with SARS-CoV-2. Methods: We searched literature in MEDLINE, Scopus, Web of Science, and Embase to find related article by using the following keywords COVID-19, SARS-CoV-2 infection, Gastrointestinal Tract, digestive system. The heterogeneity of included studies was quantified with the I2 statistic. A random-effects model was used to estimate the pooled prevalence and a meta-regression method was utilized to investigate the factors affecting heterogeneity between studies. Results: Of 3028 retrieved documents, 111 studies with 21126 COVID-19 cases were included. The prevalence of any Gastrointestinal symptoms was 17.22% (14.48 to 20.13). The prevalence of diarrhea was 13.75% (12.07 to 15.44), anorexia 27.41% (21.53 to 33.29) and Nausea/vomiting 8.11% (6.87 to 9.35). Furthermore, the prevalence of other symptoms in current study was fever 76.70% (73.42 to 79.83), cough 58.07% (54.59 to 61.52) and dyspnea/shortness of breath 24.63% (20.06 to 29.48). According to meta-regression results, age (p: 0.027) and fever (p<0.001) had significant effect on prevalence of any Gastrointestinal symptoms. Conclusion: The anorexia, diarrhea, nausea, and vomiting are the most common Gastrointestinal presentations. Copyright © 2021 Tehran University of Medical Sciences.
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