Gastrointestinal and hepatic manifestations of <scp>COVID</scp>‐19: A systematic review and meta‐analysis

Dorrell, Robert; Dougherty, Michael; Barash, Eric; Lichtig, Asher; Clayton, Steven; Jensen, Elizabeth T.

doi:10.1002/jgh3.12456

Cited by 27 publications

(31 citation statements)

References 57 publications

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“…Clinical presentation of COVID-19-positive subjects was in line with previous studies, with cough, fever, and loss of smell being the most commonly reported symptoms ( 2 ). Interestingly, we have shown that diarrhea was inversely correlated with disease risk, which was in disagreement with a recent systematic review that had suggested that gastrointestinal symptoms were experienced by 13% of all patients ( 17 ). Although the ROC estimates in this study seem rather high, new approaches predicting critical patients have managed to yield even greater estimates ( 18 ).…”

Section: Discussioncontrasting

confidence: 99%

Rapid COVID-19 Antigen Testing in Croatia: Risk Perception Plays an Important Role in the Epidemic Control

Primorac

Perić²,

Matišić³

et al. 2021

Front. Public Health

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Aim: To explore the clinical presentation and epidemiological history of the subjects who underwent SARS-CoV-2 antigen testing.Methods: We included 1,000 consecutive subjects who presented themselves at the diagnostic clinic in Croatia and analyzed their symptoms and epidemiological history. All subjects were classified into three groups, according to their reason of arrival; symptomatic, contacts of confirmed patients, and those who were tested due to administrative reasons.Results: On average, there were 24% of positive antigen results; the positivity rate was 51% among symptomatic, 16% in contacts, and 5% of administrative patients. The commonest symptoms of the disease included febrility and anosmia. We developed a clinical score to predict SARS-CoV-2 positivity, which had an area under the curve of 79.3 [95% confidence intervals (CI) 75.8–82.8]. Contact with the isolated person [odds ratio 0.54 (95% CI 0.31–0.94)] and international travel had a protective effect [0.20 (0.09–0.43)], suggesting that risk perception and mandatory pretravel measures had a key role in the determination of the infection risk.Conclusions: A combination of clinical symptoms can have reasonable predictive power for an antigen-positive test result. Risk perception seems to have a role in the epidemic spread, probably via stricter adherence to personal preventative measures.

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Section: Discussioncontrasting

confidence: 99%

Rapid COVID-19 Antigen Testing in Croatia: Risk Perception Plays an Important Role in the Epidemic Control

Primorac

Perić²,

Matišić³

et al. 2021

Front. Public Health

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“…In contrast, a recent study reported a significantly higher prevalence of GI manifestations in critically ill and hospitalized patients [ 24 ]. Another analysis by Dorrel et al reported a high prevalence of GI manifestations in severe COVID-19 patients [ 25 ]. A similar trend was noted in our study with more prevalence of GI manifestations in severe COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

Association of Gastrointestinal System With Severity and Mortality of COVID-19: A Systematic Review and Meta-Analysis

Menon¹,

Sharma²,

Earthineni³

et al. 2021

Cureus

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At present, the novel coronavirus disease (COVID-19) is causing a major pandemic. COVID-19 is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). In COVID-19, the patient usually presents with fever, dry cough, and respiratory manifestations. However, the involvement of other systems has also been reported in the literature. Abdominal pain, diarrhea, vomiting, and nausea are the predominant gastrointestinal (GI) manifestations underlined in the literature. We conducted a literature search using four databases (PubMed, Web of Science, Google Scholar, and Clinicaltrials.gov ). Our search strategy included Medical Subject Headings (MeSH) terms and keywords for COVID-19, SARS-CoV-2, and GI system from inception to October 2020. After excluding duplicates, review articles, and non-relevant articles, we included 20 studies out of 842 articles reporting GI manifestations in COVID-19 patients. Using Cochrane RevMan version 5.4 (Cochrane, London, UK), a compute pooled analysis using a random-effect model was performed. Our study included 6,022 patients with a median age of 49.5 years. Pooled analysis via random effect model revealed an increased risk of severe COVID-19 in patients manifesting GI symptoms with an odds ratio (OR) of 2.07 (95% Confidence Interval [CI]: 1.34-3.18) with I 2 =41%). Odds of mortality in COVID-19 with GI manifestation and hepatic abnormalities included 0.92 (95% CI: 0.50-1.69) (I 2 =57%) and 1.26 (95% CI: 0.67-2.37) (I 2 =0%), respectively. Severe COVID-19 may have a strong association with GI manifestations and have a significant impact on GI practice. Holistic knowledge of the spectrum of the GI consequences in COVID-19 is crucial to get a hold of virus spread. In this article, we have summarized the association of GI manifestations in severe COVID-19 patients.

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“…Gastrointestinal symptoms are relatively common in human patients with COVID-19, and in approximately 2% of human cases, symptoms are restricted to the gastrointestinal tract. 25 Gastrointestinal symptoms can be the earliest or the primary manifestation of human disease. 21,22,[26][27][28] In humans, SARS-CoV-2 infection can cause gastrointestinal bleeding, ulceration, and ischemia from thromboembolism.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Manifestation of Severe SARS-CoV-2 Infection in an Immunocompromised Dog

Lennon¹,

Oceguera²,

Braun³

et al. 2021

Preprint

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SARS-CoV-2 infects a range of host species. However, the susceptibility of companion animals to SARS-CoV-2 and their potential ability to transmit the virus to humans remains unclear. Here, we present a detailed clinical description of an immunosuppressed dog that was infected with SARS-CoV-2. The dog had severe gastrointestinal (GI) clinical signs, coagulopathy, elevated hepatic transaminases, and met canine systemic inflammatory response syndrome criteria, without respiratory clinical signs, mirroring a subset of humans with GI-restricted COVID-19. Viral sequencing demonstrated divergence from other reported sequences, based on phylogenetic analysis. The dog shed high levels of virus for a prolonged time period with positive virus isolation. The dog’s immunosuppressed state may have increased both susceptibility to infection and disease progression. Together, our findings suggest that certain individual companion animals may be at higher risk for severe SARS-CoV-2 infection, COVID-19-like disease, and high viral shedding, which may pose a transmission risk to humans.

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Gastrointestinal and hepatic manifestations of COVID‐19: A systematic review and meta‐analysis

Cited by 27 publications

References 57 publications

Rapid COVID-19 Antigen Testing in Croatia: Risk Perception Plays an Important Role in the Epidemic Control

Rapid COVID-19 Antigen Testing in Croatia: Risk Perception Plays an Important Role in the Epidemic Control

Association of Gastrointestinal System With Severity and Mortality of COVID-19: A Systematic Review and Meta-Analysis

Gastrointestinal Manifestation of Severe SARS-CoV-2 Infection in an Immunocompromised Dog

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