Suresh Kumar Vishnu Charan, Mukherjee Samiran, Harne Prateek Suresh, Subedi Abinash, Ganapathy Muthu Kuzhali, Patthipati Venkata Suresh, Sapkota Bishnu
Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA
Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
BMJ Open Gastroenterol. 2020 May;7(1). doi: 10.1136/bmjgast-2020-000417.
The COVID-19 epidemic has affected over 2.6 million people across 210 countries. Recent studies have shown that patients with COVID-19 experience relevant gastrointestinal (GI) symptoms. We aimed to perform a systematic review and meta-analysis on the GI symptoms of COVID-19.
A literature search was conducted via electronic databases, including PubMed, Embase, Scopus, and Google Scholar, from inception until 20 March 2020. Data were extracted from relevant studies. A systematic review of GI symptoms and a meta-analysis comparing symptoms in severe and non-severe patients was performed using RevMan V.5.3.
Pooled data from 2477 patients with a reverse transcription-PCR-positive COVID-19 infection across 17 studies were analysed. Our study revealed that diarrhoea (7.8%) followed by nausea and/or vomiting (5.5 %) were the most common GI symptoms. We performed a meta-analysis comparing the odds of having GI symptoms in severe versus non-severe COVID-19-positive patients. 4 studies for nausea and/or vomiting, 5 studies for diarrhoea and 3 studies for abdominal pain were used for the analyses. There was no significant difference in the incidence of diarrhoea (OR=1.32, 95% CI 0.8 to 2.18, Z=1.07, p=0.28, I=17%) or nausea and/or vomiting (OR=0.96, 95% CI 0.42 to 2.19, Z=0.10, p=0.92, I=55%) between either group. However, there was seven times higher odds of having abdominal pain in patients with severe illness when compared with non-severe patients (OR=7.17, 95% CI 1.95 to 26.34, Z=2.97, p=0.003, I=0%).
Our study has reiterated that GI symptoms are an important clinical feature of COVID-19. Patients with severe disease are more likely to have abdominal pain as compared with patients with non-severe disease.
新型冠状病毒肺炎（COVID-19）疫情已影响210个国家的260多万人。最近的研究表明，COVID-19患者会出现相关的胃肠道（GI）症状。我们旨在对COVID-19的胃肠道症状进行系统评价和荟萃分析。
通过电子数据库进行文献检索，包括PubMed、Embase、Scopus和谷歌学术，检索时间从数据库建立至2020年3月20日。从相关研究中提取数据。使用RevMan V.5.3对胃肠道症状进行系统评价，并对重症和非重症患者的症状进行荟萃分析。
分析了17项研究中2477例逆转录聚合酶链反应（RT-PCR）检测COVID-19感染呈阳性患者的汇总数据。我们的研究显示，腹泻（7.8%）是最常见的胃肠道症状，其次是恶心和/或呕吐（5.5%）。我们进行了一项荟萃分析，比较重症和非重症COVID-19阳性患者出现胃肠道症状的几率。分析使用了4项关于恶心和/或呕吐的研究、5项关于腹泻的研究以及3项关于腹痛的研究。两组之间腹泻（比值比[OR]=1.32，95%置信区间[CI] 0.8至2.18，Z=1.07，p=0.28，I²=17%）或恶心和/或呕吐（OR=0.96，95%CI 0.42至2.19，Z=0.10，p=0.92，I²=55%）的发生率均无显著差异。然而，与非重症患者相比，重症患者出现腹痛的几率高出7倍（OR=7.17，95%CI 1.95至26.34，Z=2.97，p=0.003，I²=0%）。
我们的研究重申，胃肠道症状是COVID-19的一个重要临床特征。与非重症患者相比，重症患者更易出现腹痛。
