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Acta Gastroenterol Belg . Prevalence of gastrointestinal symptoms in coronavirus disease 2019: a meta-analysis

tetano

Editor, Senior Moderator
Acta Gastroenterol Belg


. Oct-Dec 2020;83(4):603-615.

Prevalence of gastrointestinal symptoms in coronavirus disease 2019: a meta-analysis


E Merola[SUP] 1 [/SUP], F Armelao[SUP] 1 [/SUP], G de Pretis[SUP] 1 [/SUP]



Affiliations
  • PMID: 33321018

Abstract

Background and study aims: The coronavirus disease 2019 (COVID-19) is a pandemic infection spreading worldwide at an unprecedented rate. Our aim was to assess the frequency of gastrointestinal (GI) involvement in COVID-19.
Patients and methods: We performed a systematic review and meta-analysis of all studies reporting clinical data about COVID-19 patients, published until 25th March 2020. The primary endpoint was the pooled prevalence of COVID-19 patients complaining of GI symptoms. Secondary endpoints were the pooled prevalence of cases with COVID-19 positive stool samples, and of asymptomatic COVID-19 patients. We used random-effects model for meta-analysis.
Results: Thirty-three studies were included in the meta-analysis. Out of 4434 COVID-19 patients, the pooled prevalence of GI manifestations was 11.51% (95% CI : 8.16 to 15.35). The most frequent GI symptom was diarrhea (7.78% of cases ; 95% CI : 5.05 to 11.04), followed by nausea/vomiting (3.57% ; 95% CI : 1.87 to 5.80), poor appetite (2.39% ; 95%CI : 0.55 ; 5.46) and abdominal pain (0.78% ; 95% CI : 0.26 to 1.57). Positivity for COVID-19 in stool samples was observed in 41.50% (95% CI : 17.70 to 67.65) of cases. 11.85% (95% CI : 3.53 to 24.17) of COVID-19 patients remained asymptomatic.
Conclusions: The present meta-analysis shows that a significant proportion of COVID-19 patients suffer from GI manifestations, as well as COVID-19 positivity in stool samples. Asymptomatic patients need to be considered a further potential route of viral transmission.

Keywords: COVID-19; asymptomatic patients; fecal-oral viral transmission; gastrointestinal symptoms.
 
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