Abstract

Muhammad Saif Ullah, Saher Taj Shiza, Moyosoreoluwa Onobun, Warda Shahnawaz, Mercy Ekeoma Azubuko-Udah, Muneeba Ali, Syeda Sumbul Zahra Zaidi, Usama Rehman

ABSTRACT

Objective: At present, the novel coronavirus disease (COVID-19) is causing a major pandemic. COVID-19 is caused by Severe Acute Respiratory Syndrome-2 (SARS-COV-2). In COVID-19, the patient generally presents with fever, dry cough, and respiratory and signs and symptoms. Other system involvement has also been reported. Abdominal pain, diarrhea, vomiting, and nausea are the predominant gastrointestinal symptoms, underlined in the literature. In this article, we summarized the important GIT characteristics of the disease. Methods: We conducted a literature search using four databases (PubMed, Google Scholar, Web of Science, and Clinicaltrials.gov). Our search strategy included MeSH terms and keywords for COVID-19, SARS-CoV-2, and gastrointestinal system from inception to December 2020. After excluding review articles, duplicates, and non-relevant, we included 60 studies out of 558 articles reporting gastrointestinal (GI) manifestations such as nausea, vomiting, abdominal pain, and diarrhea. Using the 'meta' package (Schwarzer et al.) in the R programming language, version 4.0.2, a compute pooled analysis using the random effect model was performed. Results: The overall prevalence any GI signs and symptoms in affected patients with COVID-19, was 27% (95% CI: 21-35) (p<0.05) (I2 =94%).GI as an initial presentation was reported in five studies with prevalence of 34% (95% CI: 05-83) (p<0.01) (I2 =88%), diarrhea 16% (95% CI: 12-19) (p=0.01) (I2 =94), anorexia 29% (95% CI: 22-38) (p<0.01) (I2 =96%), abdominal pain 16% (95% CI: 11-20) (p<0.01) (I2 =95%), and nausea/vomiting 17% (95% CI: 13-22) (p<0.01) (I2 =88%). Severe COVID-19 with GI symptoms were reported with prevalence of 25% (95%CI: 19-31) (p<0.01) (I2 =90%). Haptic abnormality was reported with prevalence of 22% (95% CI: 14-33) (p<0.01) (I2 =97%). Conclusion: We perceive that COIVD-19 may have several gastrointestinal manifestations, and in many cases, GI involvement may precede typical upper respiratory tract symptoms. Holistic knowledge of the spectrum of the COVID-19 GI consequences is crucial to get a hold of the virus spread.