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Gastroenterology manifestations and COVID-19 outcomes: A meta-analysis of 25,252 cohorts among the first and second waves.

Abstract：

BACKGROUND AND AIM:A meta-analysis was performed to identify COVID-19 patients presenting with gastrointestinal (GI) symptoms during the first and second pandemic waves and investigate their association with the disease outcomes. METHODS:A systematic search in PubMed, Scopus, Web of Science, ScienceDirect, and EMBASE was performed up to July 25, 2020. The pooled prevalence of the GI presentations was estimated using the random-effects model. Pairwise comparison for the outcomes was performed according to the GI manifestations' presentation and the pandemic wave of infection. Data were reported as relative risk (RR), or odds ratio (OR) and 95% confidence interval (CI). RESULTS:Of 125 articles with 25,252 patients, 20.3% presented with GI manifestations. Anorexia (19.9%), dysgeusia/ageusia (15.4%), diarrhea (13.2%), nausea (10.3%), and hematemesis (9.1%) were the most common. About 26.7% had confirmed positive fecal RNA, with persistent viral shedding for an average time of 19.2 days before being negative. Patients presenting with GI symptoms on admission showed a higher risk of complications, including acute respiratory distress syndrome (RR=8.16), acute cardiac injury (RR=5.36), and acute kidney injury (RR=5.52), ICU admission (RR=2.56), and mortality (RR=2.01). Although not reach significant levels, subgroup-analysis revealed that affected cohorts in the first wave had a higher risk of being hospitalized, ventilated, ICU admitted, and expired. CONCLUSIONS:This meta-analysis suggests an association between GI symptoms in COVID-19 patients and unfavorable outcomes. The analysis also showed improved overall outcomes for COVID-19 patients during the second wave compared to the first wave of the outbreak. This article is protected by copyright. All rights reserved.

journal_name

J Med Virol

journal_title

Journal of medical virology

authors

Elshazli RM,Kline A,Elgaml A,Aboutaleb MH,Salim MM,Omar M,Munshi R,Mankowski N,Hussein MH,Attia AS,Toraih EA,Settin A,Killackey M,Fawzy MS,Kandil E

doi

10.1002/jmv.26836

subject

Has Abstract

pub_date

2021-02-02 00:00:00

eissn

0146-6615

issn

1096-9071

pub_type

杂志文章,评审

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Gastroenterology manifestations and COVID-19 outcomes: A meta-analysis of 25,252 cohorts among the first and second waves.