The liver injury and gastrointestinal symptoms in patients with Coronavirus Disease 19: A systematic review and meta-analysis

Clin Res Hepatol Gastroenterol. 2020 Oct;44(5):653-661. doi: 10.1016/j.clinre.2020.04.012. Epub 2020 May 12.

Abstract

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.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Abdominal Pain / epidemiology
  • Betacoronavirus*
  • COVID-19
  • China / epidemiology
  • Coronavirus Infections / complications*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / mortality
  • Diarrhea / epidemiology
  • Diarrhea / virology
  • Gastrointestinal Diseases / epidemiology*
  • Gastrointestinal Diseases / virology
  • Humans
  • Liver Diseases / epidemiology*
  • Liver Diseases / virology
  • Nausea / epidemiology
  • Nausea / virology
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / mortality
  • Prevalence
  • Prognosis
  • SARS-CoV-2
  • Severity of Illness Index
  • Symptom Assessment
  • Vomiting / epidemiology