The Liver Injury and Gastrointestinal Symptoms in Patients With Coronavirus Disease 19: A Systematic Review and Meta-Analysis

Clin Res Hepatol Gastroenterol. 2020 May 12;S2210-7401(20)30117-0. doi: 10.1016/j.clinre.2020.04.012. Online ahead of print.


Backgrounds: Since December 2019, novel coronavirus (SARS-CoV-2)-infected pneumonia (COVID-19) occurred in Wuhan, and rapidly spread throughout China. Our study aimed to evaluate the association of liver injury and gastrointestinal symptoms (GIS) with the progression of COVID-19.

Methods: A comprehensive search was performed on the PubMed to identify eligible studies that summarized the liver injury and GIS in COVID-19.

Results: A total of 21 studies with 3024 patients were included. Up to 53% patients had liver dysfunctions and the degree of liver damage was associated the severity of the disease. The prevalence of diarrhoea, nausea/vomiting or abdominal pain in patients with COVID-19 were 9.1%, 5.2% and 3.5%, respectively. No significant was found in the prevalence of diarrhoea (OR, 1.24; 95%CI, 0.90 to 1.72; I2=0%, P=0.19) and nausea/vomiting (OR, 1.24; 95%CI, 0.57 to 2.69; I2=61%, P=0.58) between severe and non-severe patients. In addition, diarrhoea (OR, 1.22; 95%CI, 0.50 to 2.98; I2=0%, P=0.66) and nausea/vomiting (OR, 1.09; 95%CI, 0.46 to 2.62; I2=0%, P=0.84) were not associated with the prognosis of COVID-19 patients.

Conclusions: The incidences of GIS in patients with COVID-19 is relatively low and are not associated with the COVID-19 progression. Gastroenterologists should pay more attention to the liver injury induced by SARS-CoV-2 during the course of infection.

Keywords: COVID-19; Diarrhoea; Gastrointestinal symptoms; Liver injury; SARS-CoV-2.