Gastrointestinal predictors of severe COVID-19: systematic review and meta-analysis.
Gastrointestinal predictors of severe COVID-19: systematic review and meta-analysis.
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DOI：
10.20524/aog.2020.0527
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发表时间：
2020-11
影响因子：
2.2
通讯作者：
Adler DG
中科院分区：
文献类型：
--
作者：
Aziz M;Haghbin H;Lee-Smith W;Goyal H;Nawras A;Adler DG
COVID-19大流行需要识别严重疾病的潜在预测因素。我们对严重COVID-19的胃肠道预测因素进行了系统回顾和荟萃分析。使用PubMed、Embase、Web of Science和科克伦进行了广泛的文献检索。使用随机效应模型计算比例和连续结局的比值比（OR）和平均差（MD）。对于每个结局，生成95%置信区间（CI）和P值。共纳入83项研究（26912例患者，平均年龄43.5±16.4岁，48.2%为女性）。严重COVID-19的胃肠道预测因素包括腹泻的存在（OR 1.50，95%CI 1.10-2.03; P=0.01），血清天冬氨酸转氨酶（AST）升高（OR 4.00，95%CI 3.02-5.28; P<0.001）和血清丙氨酸氨基转移酶（ALT）升高（OR 2.54，95%CI 1.91-3.37; P<0.001）。平均AST水平显著升高（MD 14.78 U/L，95%CI 11.70-17.86 U/L; P<0.001），ALT（MD 11.87 U/L，95%CI 9.23-14.52 U/L; P<0.001），总胆红素（MD 2.08 mmol/L，95%CI 1.36-2.80 mmol/L; P<0.001）。应及早评估胃肠道症状和生物标志物，以识别严重的COVID-19。
COVID-19 pandemic has created a need to identify potential predictors of severe disease. We performed a systematic review and meta-analysis of gastrointestinal predictors of severe COVID-19. An extensive literature search was performed using PubMed, Embase, Web of Science and Cochrane. Odds ratio (OR) and mean difference (MD) were calculated for proportional and continuous outcomes using a random-effect model. For each outcome, a 95% confidence interval (CI) and P-value were generated. A total of 83 studies (26912 patients, mean age 43.5±16.4 years, 48.2% female) were included. Gastrointestinal predictors of severe COVID-19 included the presence of diarrhea (OR 1.50, 95%CI 1.10-2.03; P=0.01), elevated serum aspartate aminotransferase (AST) (OR 4.00, 95%CI 3.02-5.28; P<0.001), and elevated serum alanine aminotransferase (ALT) (OR 2.54, 95%CI 1.91-3.37; P<0.001). Significantly higher levels of mean AST (MD 14.78 U/L, 95%CI 11.70-17.86 U/L; P<0.001), ALT (MD 11.87 U/L, 95%CI 9.23-14.52 U/L; P<0.001), and total bilirubin (MD 2.08 mmol/L, 95%CI 1.36-2.80 mmol/L; P<0.001) were observed in the severe COVID-19 group compared to non-severe COVID-19 group. Gastrointestinal symptoms and biomarkers should be assessed early to recognize severe COVID-19.
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DOI：
10.3760/cma.j.issn.1001-0939.2020.0005
发表时间：
2020-02-06
期刊：
Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases
影响因子：
--
作者：
Chen, L;Liu, H G;Wei, S
通讯作者：
Wei, S
影响因子：
12.7
作者：
Duan, Jun;Wang, Xiaohui;Guo, Shuliang
通讯作者：
Guo, Shuliang
影响因子：
6.8
作者：
Bonetti, Graziella;Manelli, Filippo;Lippi, Giuseppe
通讯作者：
Lippi, Giuseppe
影响因子：
2.2
作者：
DerSimonian R;Laird N
通讯作者：
Laird N
影响因子：
15.9
作者：
Chen, Guang;Wu, Di;Ning, Qin
通讯作者：
Ning, Qin