Newly Reported Studies on the Increase in Gastrointestinal Symptom Prevalence withCOVID-19 Infection: A Comprehensive Systematic Review and Meta-Analysis.
Newly Reported Studies on the Increase in Gastrointestinal Symptom Prevalence withCOVID-19 Infection: A Comprehensive Systematic Review and Meta-Analysis.
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新报道的研究对19岁感染的胃肠道症状患病率增加：一项全面的系统评价和荟萃分析。
DOI：
10.3390/diseases8040041
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发表时间：
2020-11-10
期刊：
影响因子：
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通讯作者：
Hammoud G
中科院分区：
文献类型：
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作者：
Akin H;Kurt R;Tufan F;Swi A;Ozaras R;Tahan V;Hammoud G
背景和目的：虽然咳嗽和发热等全身和呼吸道症状是感染COVID-19患者最常见的症状，但通过内镜活检观察到胃肠道（GI）受累。还报告了多种胃肠道症状，包括腹泻、恶心或呕吐和腹痛。本综述旨在提供有关COVID-19患者胃肠道症状的当前可用数据，并比较早期（东部）主要是中国数据与当前阶段（西方）非中国数据的胃肠道症状频率。研究方法：我们使用PubMed、Google Scholar和CNKI（中文医学搜索引擎）进行了系统性文献检索，以识别已发表的研究，并通过medRxiv和bioRxiv识别尚未发表的研究。我们还审查了检测到的文章的交叉引用。我们进行了医学主题词（MeSH）检索，检索时间截止至2020年9月20日。我们使用Freeman-Tukey转换随机效应模型汇总了腹泻、厌食、恶心、呕吐和腹痛症状的患病率。结果：共纳入118篇文献，其中44篇纳入Meta分析。研究之间存在显著异质性;因此，使用随机效应模型。报告的任何GI症状的合并患病率估计值为0.21（95%CI，0.16-0.27）。厌食是最常见的GI症状，占18%（95%CI，0.10-0.27），其次是腹泻，占15%（95%CI，0.12-0.19）。腹泻、腹痛、恶心/呕吐和呼吸道症状在非中国研究中更常见。与仅包括门诊患者的研究以及包括住院患者和门诊患者的研究相比，“仅住院患者”研究中腹痛的患病率较低。结论：在这项综合性系统评价和荟萃分析研究中，我们观察到非中国研究中COVID-19感染患者的腹泻、恶心/呕吐和腹痛发生率高于中国研究。我们还观察到中国研究中GI症状的患病率高于以前的报道。非呼吸道症状，包括胃肠道症状，应在未来的研究中进行更彻底和仔细的评估和报告。
Background and Aim: Although constitutional and respiratory symptoms such as cough and fever are the most common symptoms in patients infected with COVID-19, gastrointestinal (GI) tract involvement has been observed by endoscopic biopsies. Multiple GI symptoms, including diarrhea, nausea or vomiting and abdominal pain, have also been reported. This review aims to present the currently available data regarding the GI symptoms of COVID-19 patients, and to compare the frequency of GI symptoms in early stage (Eastern) mostly Chinese data to the current stage (Western) non-Chinese data. Methods: We performed a systematic literature search to identify both published studies by using PubMed, Google Scholar, and CNKI (Chinese medical search engine), and yet unpublished studies through medRxiv and bioRxiv. We also reviewed the cross references of the detected articles. We conducted a Medical Subject Headings (MeSH) search up until 20 September 2020. We pooled the prevalence of symptoms of diarrhea, anorexia, nausea, vomiting, and abdominal pain by using the Freeman–Tukey’s transforming random effect model. Results: A total of 118 studies were included in the systematic review and 44 of them were included in the meta-analysis. There was a significant heterogeneity between the studies; therefore, the random effects model was used. The pooled prevalence estimate of any GI symptoms reported was found to be 0.21 (95%CI, 0.16–0.27). Anorexia was the most commonly reported GI symptom at 18% (95%CI, 0.10–0.27) followed by diarrhea at 15% (95%CI, 0.12–0.19). Diarrhea, abdominal pain, nausea/vomiting, and respiratory symptoms were more common in non-Chinese studies. The prevalence of abdominal pain was lower in the “inpatient-only” studies when compared with studies that included outpatients only and those including both inpatients and outpatients. Conclusions: In this comprehensive systematic review and meta-analysis study, we observed higher rates of diarrhea, nausea/vomiting, and abdominal pain in COVID-19 infected patients among non-Chinese studies compared to Chinese studies. We also observed a higher prevalence of GI symptoms in Chinese studies than was reported previously. Non-respiratory symptoms, including GI tract symptoms, should be more thoroughly and carefully evaluated and reported in future studies.