Gul Fahad, Lo Kevin Bryan, Peterson Julie, McCullough Peter A, Goyal Abhinav, Rangaswami Janani
Department of Medicine, Einstein Medical CenterPhiladelphiaPennsylvania.
Division of Cardiology, Baylor University Medical CenterDallasTexas.
Proc (Bayl Univ Med Cent). 2020 May 29;33(3):366-369. doi: 10.1080/08998280.2020.1771164. eCollection 2020 Jul.
This systematic review analyzed whether the presence or absence of gastrointestinal symptoms in patients with SARS-COV-2 infection is associated with adverse outcomes. Searching the Cochrane Center Register of Controlled Trials, we included any studies looking at patients with COVID-19 with gastrointestinal symptoms (nausea, vomiting, diarrhea, abdominal pain) compared to those with COVID-19 but without gastrointestinal manifestations as a control group. The final search yielded 186 articles, all of which were individually screened. Seven studies were identified but three were excluded: one due to lack of a control group without gastrointestinal symptoms, one reported as viral RNA in the stool, and one with only non-critically ill patients. Results of the meta-analysis showed a pooled odds ratio for mortality among those with COVID-19 and gastrointestinal symptoms of 0.91 (confidence interval 0.49-1.68) with heterogeneity of 0% and a pooled odds ratio for acute respiratory distress syndrome of 2.94 (confidence interval 1.17-7.40) with heterogeneity of 0%. In conclusion, gastrointestinal symptoms with COVID-19 are associated with a higher risk of acute respiratory distress syndrome, but do not increase the risk for mortality.
本系统评价分析了新型冠状病毒肺炎（SARS-COV-2）感染患者胃肠道症状的有无是否与不良结局相关。通过检索Cochrane对照试验中心注册库，我们纳入了任何一项研究，该研究将有胃肠道症状（恶心、呕吐、腹泻、腹痛）的新型冠状病毒肺炎（COVID-19）患者与无胃肠道表现的COVID-19患者作为对照组进行比较。最终检索得到186篇文章，所有文章均进行了单独筛选。确定了7项研究，但排除了3项：1项因缺乏无胃肠道症状的对照组，1项报告粪便中有病毒RNA，1项仅涉及非重症患者。荟萃分析结果显示，有胃肠道症状的COVID-19患者的合并死亡比值比为0.91（置信区间0.49-1.68），异质性为0%；急性呼吸窘迫综合征的合并比值比为2.94（置信区间1.17-7.40），异质性为0%。总之，COVID-19患者的胃肠道症状与急性呼吸窘迫综合征的较高风险相关，但不会增加死亡风险。
