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Meta-Analysis
. 2021 Jan;55(1):67-76.
doi: 10.1097/MCG.0000000000001424.

The Prevalence of Gastrointestinal Symptoms, Abnormal Liver Function, Digestive System Disease and Liver Disease in COVID-19 Infection: A Systematic Review and Meta-Analysis

Zi-Yuan Dong  1 , Bing-Jie Xiang, Min Jiang, Ming-Jun Sun, Cong Dai
Affiliations
Meta-Analysis

The Prevalence of Gastrointestinal Symptoms, Abnormal Liver Function, Digestive System Disease and Liver Disease in COVID-19 Infection: A Systematic Review and Meta-Analysis

Zi-Yuan Dong et al. J Clin Gastroenterol. 2021 Jan.

Abstract

Background: The worldwide outbreak of COVID-19 infected millions of people. Some patients had gastrointestinal (GI) symptoms, abnormal liver function, digestive system disease and liver disease.

Aim: To investigate the prevalence of GI symptoms, abnormal liver function, digestive system disease and liver disease in patients with COVID-19 by a systematic review and meta-analysis.

Methods: We searched PubMed, Ovid Embase, Medline, and 2 Chinese databases. Primary outcomes were the prevalence of GI symptoms, abnormal liver function, digestive system disease, and liver disease. Different studies were included in different subset analysis. These outcomes were estimated with proportions, odds ratio, 95% confidence interval (CI) and P-value by Stata SE 15.1.

Results: Thirty-one studies involving 4682 patients were included. The most significant GI symptoms were diarrhea (0.08, 95% CI: 0.06-0.11) and anorexia (0.17, 95% CI: 0.06-0.27). The most significant abnormal liver function was increased alanine aminotransferase (ALT) (0.25, 95% CI: 0.16-0.33). A total of 5% of the patients had digestive system disease (95% CI: 0.02-0.08). A total of 3% of the patients had liver disease (95% CI: 0.02-0.05). The prevalence of nausea and vomiting, diarrhea, abnormal liver function, digestive system disease, and liver disease was higher in Wuhan group. The prevalence of diarrhea was higher in non-China group. Patients in severe/intensive care unit group were more likely to have diarrhea, anorexia, abdominal pain increased aspartate aminotransferase, and increased ALT.

Conclusion: The most significant GI symptoms were anorexia and diarrhea. The most significant abnormal liver function was increased ALT. Severe patients were more likely to have GI symptoms and abnormal liver function.

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Conflict of interest statement

The authors declare that they have nothing to disclose.

Figures

FIGURE 1
FIGURE 1
A flow diagram of articles retrieved and inclusion progress through the stage of meta-analysis.
FIGURE 2
FIGURE 2
Forest plot of prevalence of diarrhea in patients with COVID-19. CI indicates confidence interval; ES, effect size.
FIGURE 3
FIGURE 3
Forest plot of prevalence of increased alanine aminotransferase in patients with COVID-19. CI indicates confidence interval; ES, effect size.
FIGURE 4
FIGURE 4
Forest plot of prevalence of digestive system disease in patients with COVID-19. CI indicates confidence interval; ES, effect size.
FIGURE 5
FIGURE 5
Forest plot of prevalence of liver disease in patients with COVID-19. CI indicates confidence interval; ES, effect size.
See this image and copyright information in PMC

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