Gastrointestinal Manifestations of the COVID-19: A Systematic Review and MetaAnalysis with 111 studies

  • Saber Soltani Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • Armin Zakeri Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
  • Iraj Pakzad Department of Microbiology, School of Medicine, Ilam University Medical Sciences, Ilam, Iran.
  • Alireza Tabibzadeh Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
  • Amir Mohammad Zakeri Pediatric Surgery Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Milad Zandi Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • Sara Akhavan Rezayat Department of Health Care Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • Mehrzad Jafarzadeh Endocrine research center, institute of Endocrinology and Metabolism, Iran University of Medical Science, Tehran, Iran.
  • Parinaz Khalkhali Asl Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Golestan, Iran.
  • Arghavan Zebardast Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • Yousef Erfani Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University Medical Sciences, Tehran, Iran.
  • Ramin Shahbahrami Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran.
  • Reza Pakzad Department of Epidemiology, Faculty of Health, Ilam University Medical Sciences, Ilam, Iran.
  • Pooneh Malekifar Department of Epidemiology, School of Public Health, Tehran University Medical Sciences, Tehran, Iran.
Keywords: COVID-19; SARS-CoV-2; Gastrointestinal Tract; Systematic Review; Meta-Analysis.

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.

Published
2022-08-29
Section
Articles