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Meta-Analysis
. 2022 Mar 7;22(1):106.
doi: 10.1186/s12876-022-02132-0.

Are gastrointestinal symptoms associated with higher risk of Mortality in COVID-19 patients? A systematic review and meta-analysis

Yang Wang #  1   2 , Yimin Li #  3 , Yifan Zhang  1   2 , Yun Liu  1   2 , Yulan Liu  4   5
Affiliations
Meta-Analysis

Are gastrointestinal symptoms associated with higher risk of Mortality in COVID-19 patients? A systematic review and meta-analysis

Yang Wang et al. BMC Gastroenterol. .

Abstract

Background: Gastrointestinal symptoms have been reported in patients with COVID-19. Several clinical investigations suggested that gastrointestinal symptoms were associated with disease severity of COVID-19. However, the relevance of gastrointestinal symptoms and mortality of COVID-19 remains largely unknown. We aim to investigate the relationship between gastrointestinal symptoms and COVID-19 mortality.

Methods: We searched the PubMed, Embase, Web of science and Cochrane for studies published between Dec 1, 2019 and May 1, 2021, that had data on gastrointestinal symptoms in COVID-19 patients. Additional literatures were obtained by screening the citations of included studies and recent reviews. Only studies that reported the mortality of COVID-19 patients with/without gastrointestinal symptoms were included. Raw data were pooled to calculate OR (Odds Ratio). The mortality was compared between patients with and without gastrointestinal symptoms, as well as between patients with and without individual symptoms (diarrhea, nausea/vomiting, abdominal pain).

Results: Fifty-three literatures with 55,245 COVID-19 patients (4955 non-survivors and 50,290 survivors) were included. The presence of GI symptoms was not associated with the mortality of COVID-19 patients (OR=0.88; 95% CI 0.71-1.09; P=0.23). As for individual symptoms, diarrhea (OR=1.01; 95% CI 0.72-1.41; P=0.96), nausea/vomiting (OR=1.16; 95% CI 0.78-1.71; P=0.46) and abdominal pain (OR=1.55; 95% CI 0.68-3.54; P=0.3) also showed non-relevance with the death of COVID-19 patients.

Conclusions: Gastrointestinal symptoms are not associated with higher mortality of COVID-19 patients. The prognostic value of gastrointestinal symptoms in COVID-19 requires further investigation.

Keywords: COVID-19; Gastrointestinal symptom; Mortality; Prognosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart showing the flow of study selection
Fig. 2
Fig. 2
Forest plots showing pooled odds ratio of gastrointestinal symptoms associated with the mortality of COVID-19
Fig. 3
Fig. 3
Forest plots showing pooled odds ratio of (A) diarrhea, (B) nausea/vomiting and (C) abdominal pain associated with the mortality of COVID-19
Fig. 4
Fig. 4
Funnel plots for evaluation of publication bias. A shows the funnel plots of gastrointestinal symptoms, diarrhea, nausea/vomiting and abdominal pain. B shows the funnel plots after trim-and-fill method
See this image and copyright information in PMC

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