Severe rate is more than 40% in COVID-19 patients with gastrointestinal symptoms

Objectives:
Are gastrointestinal symptoms among COVID-19 patients associated with the severity?

Study design:
This review article included a total of 21 observational studies with 5,285 COVID-19 patients.

Gastrointestinal symptoms include diarrhea, abdominal pain, nausea and vomiting.

Results and conclusions:   
The investigators found the severe rate of COVID-19 patients with diarrhea was 41.1% [95% CI = 31.0 to 51.5%] and the OR of association between diarrhea and severe COVID-19 was 1.41 [95% CI = 1.05 to 1.89].
Sensitivity analysis showed that the results for the OR and 95% CI were unstable.

The investigators found for abdominal pain, the severe rate and OR of association with severe COVID-19 were 59.3% [95% CI = 41.3 to 76.4%] and 2.76 [95% CI = 1.59 to 4.81], respectively.

The investigators found for nausea, the severe rate and OR of association with severe COVID-19 were 41.4% [95% CI = 23.2 to 60.7%] and 0.92 [95% CI = 0.59 to 1.43], respectively.

The investigators found for vomiting, the severe rate and OR of association with severe COVID-19 were 51.3% [95% CI = 36.8 to 65.8%] and 1.68 [95% CI = 0.97 to 2.92], respectively.

The investigators concluded that the severe rate is more than 40% in COVID-19 patients with gastrointestinal symptoms. Abdominal pain is associated with a near 2.8-fold increased risk of severe COVID-19. However, the relationship between diarrhea and the severity of COVID-19 is regionally different and nausea and vomiting are limited in association with an increased risk of severe COVID-19.

Original title:
Gastrointestinal symptoms are associated with severity of coronavirus disease 2019: a systematic review and meta-analysis by Zeng W, Qi K, [...], Wei YY.

Link:
https://pubmed.ncbi.nlm.nih.gov/33470700/

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