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?:abstract
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Aim: The current research aimed to analyze and summarize observational studies that compared the incidence of gastrointestinal symptoms in mild and severe COVID-19 infection Background: Coronavirus disease 2019 (COVID-19) has been identified as a public health threat worldwide Previous studies, however, have reported contradictory results of COVID-19-related gastrointestinal symptoms in severe and mild forms Methods: A search of Medline, ISI Web of Science, EMBASE, and Cochrane Library databases was conducted for articles published up to May 2020 Data from each study was combined using the random-effects model to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) Sensitivity was examined by sequentially excluding one study in each turn Publication bias was evaluated using the Egger’s and Begg’s tests Results: Twenty studies (4,265 patients) were reviewed It was found that the prevalence of diarrhea [OR (0 40), (95% CI 0 91, - 2 16), p = 0 03, I2 = 88 1%, PHeterogenity = 0 00)] and nausea and vomiting [OR (0 27), (95% CI 0 07, 1 01), p = 0 05, I2 = 89 3%, PHeterogenity = 0 00)] increased significantly in the severe form compared to the mild form of COVID-19, while abdominal pain and anorexia had no significant increased prevalence in admitted and hospitalized COVID-19 patients Moreover, COVID-19-related gastrointestinal symptoms were seen in higher rates in males [OR (1 42), (95% CI 1 23, 1 65), p < 0 05, I2= 18 4%, PHeterogenity = 0 23] than in females No significant publication bias was observed in the meta-analysis Sensitivity analyses showed a similar effect size while reducing the heterogeneity Conclusion: The data provides valuable information for the discovery of prognosis biomarkers to diagnosis more severe disease in the early stages of COVID-19 © 2020 RIGLD, Research Institute for Gastroenterology and Liver Diseases
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