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- Title
Gastrointestinal and hepatic abnormalities in patients with confirmed COVID‐19: A systematic review and meta‐analysis.
- Authors
Zarifian, Ahmadreza; Zamiri Bidary, Mohammad; Arekhi, Soheil; Rafiee, Mahdi; Gholamalizadeh, Hanieh; Amiriani, Amirhosein; Ghaderi, Mohammad Sajjad; Khadem‐Rezaiyan, Majid; Amini, Mahnaz; Ganji, Azita
- Abstract
Although not common, gastrointestinal and liver symptoms have reportedly been the initial presentation of coronavirus disease‐2019 (COVID‐19) in a large group of patients. Therefore, knowing the frequency and characteristics of these manifestations of COVID‐19 is important for both clinicians and health policy makers. A systematic review and meta‐analysis of the available data on the gastrointestinal and liver manifestations of patients with COVID‐19 was performed. PubMed and Scopus databases and Google Scholar search engine were searched for published and unpublished preprint articles up to 10 April 2020. Original studies providing information on clinical digestive symptoms or biomarkers of liver function in patients with polymerase chain reaction confirmed diagnosis of COVID‐19 were included. After quality appraisal, data were extracted. Prevalence data from individual studies were pooled using a random‐effects model. Overall, 67 studies were included in this systematic review and meta‐analysis, comprising a pooled population of 13 251 patients with confirmed COVID‐19. The most common gastrointestinal symptoms were anorexia (10.2%, 95% confidence interval [CI] = 6.2%‐16.4%), diarrhea (8.4%, 95% CI = 6.2%‐11.2%), and nausea (5.7%, 95% CI = 3.7%‐8.6%), respectively. Decreased albumin levels (39.8%, 95% CI = 15.3%‐70.8%), increased aspartate aminotransferase (22.8%, 95% CI = 18.1%‐28.4%), and alanine aminotransferase (20.6%, 95% CI = 16.7%‐25.1%) were common hepatic findings. After adjusting for preexisting gastrointestinal (5.9%) and liver diseases (4.2%), the most common gastrointestinal findings were diarrhea (8.7%, 95% CI = 5.4%‐13.9%), anorexia (8.0%, 95% CI = 3.0%‐19.8%), and nausea (5.1%, 95% CI = 2.2%‐14.3%). Gastrointestinal and liver manifestations are not rare in patients with COVID‐19, but their prevalence might be affected by preexisting diseases. Diarrhea and mild liver abnormalities seem to be relatively common in COVID‐19, regardless of comorbidities Highlights: Anorexia (10.2%), diarrhea (8.4%), and nausea (5.7%) were the most common gastrointestinal manifestations in confirmed COVID‐19 patients.Serum albumin reduction (39.8%), AST elevation (22.8%), and ALT elevation (20.6%) were the most common hepatic abnormalities in confirmed COVID‐19 patients.Preexisting gastrointestinal and liver diseases were present in 5.9% and 4.2% of COVID‐19 patients. After adjusting for these illnesses, diarrhea (8.7%) became the most prevalent gastrointestinal finding.The prevalence of gastrointestinal and hepatic abnormalities were markedly higher in patients with severe COVID‐19 infection, compared to non‐severe cases.
- Subjects
GOOGLE Scholar (Web resource); COVID-19; ASPARTATE aminotransferase; ALANINE aminotransferase; GASTROINTESTINAL diseases; SEARCH engines
- Publication
Journal of Medical Virology, 2021, Vol 93, Issue 1, p336
- ISSN
0146-6615
- Publication type
Article
- DOI
10.1002/jmv.26314