Department of Gastroenterology and Hepatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Center of Laboratory Medicine, Union Hospital of Fujian Medical University, Fuzhou, Fujian, China.
J Gastroenterol Hepatol. 2021 Jun;36(6):1414-1422. doi: 10.1111/jgh.15323. Epub 2020 Dec 22.
A worldwide outbreak of coronavirus disease 2019 (COVID-19) has drawn global attention. Several reports have described the gastrointestinal (GI) manifestations in the infected patients. The systematic review was designed to highlight the gaps in our knowledge about the prevalence and clinical significance of GI symptoms in patients with COVID-19.
We searched PubMed database and Google articles published in both English and Chinese up to June 3, 2020, using search terms "clinical features," "2019 novel coronavirus," "2019-nCoV," "COVID-19," or "SARS-Cov-2." Observational studies, case reports, or letters describing the clinical features or observational studies regarding the detection and/or isolation of severe acute respiratory syndrome coronavirus 2 viruses in stools were included.
A total of 22 publications were finally selected. It was reported that GI symptoms occurred in about 3-40.7% of patients. GI manifestations included nausea, diarrhea, anorexia, vomiting, abdominal pain, belching, abdominal distension, and GI hemorrhage. Diarrhea was the most common GI symptom. Infected patients had various degrees of liver dysfunction, and the severity of liver dysfunction was significantly associated with the severity of the disease. Therapy focusing on digestive system like liver supportive therapy or nutrition support or probiotics has been demonstrated to be effective interventions, which greatly improve prognosis. Fecal-oral transmission route is a potential risk for transmission.
GI symptoms are common in COVID-19. Strengthening the recognition on abnormalities in digestive system of patients with COVID-19 is crucial for early identification and timely treatment, especially for those atypical patients. Hygiene protection and keeping the drainpipe free flowing are necessary for everyone.
新型冠状病毒病 2019（COVID-19）在全球范围内爆发，引起了全球关注。有几项报告描述了感染患者的胃肠道（GI）表现。本系统评价旨在突出我们对 COVID-19 患者中 GI 症状的患病率和临床意义的认识差距。
我们检索了截至 2020 年 6 月 3 日在 PubMed 数据库和中英文 Google 文章中使用的“临床特征”、“2019 年新型冠状病毒”、“2019-nCoV”、“COVID-19”或“SARS-CoV-2”等搜索词。纳入描述临床特征或关于检测和/或分离粪便中严重急性呼吸综合征冠状病毒 2 病毒的观察性研究、病例报告或信件的研究。
共最终选择了 22 篇出版物。据报道，约 3-40.7%的患者出现 GI 症状。GI 表现包括恶心、腹泻、厌食、呕吐、腹痛、嗳气、腹胀和胃肠道出血。腹泻是最常见的 GI 症状。感染患者有不同程度的肝功能障碍，肝功能障碍的严重程度与疾病的严重程度显著相关。以消化系统为重点的治疗，如护肝治疗、营养支持或益生菌治疗，已被证明是有效的干预措施，可极大地改善预后。粪-口传播途径是一种潜在的传播风险。
GI 症状在 COVID-19 中很常见。加强对 COVID-19 患者消化系统异常的认识对于早期识别和及时治疗至关重要，尤其是对那些非典型患者。每个人都有必要进行卫生保护和保持排水管道畅通。
