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The liver injury and gastrointestinal symptoms in patients with Coronavirus Disease 19: A systematic review and meta-analysis - 11/10/20

Doi : 10.1016/j.clinre.2020.04.012 
Haizhou Wang a, b, Peishan Qiu a, b, Jing Liu a, b , Fan Wang a, b , Qiu Zhao a, b,
a Department of Gastroenterology, Zhongnan Hospital of Wuhan University, 430071 Wuhan, China 
b Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China 

Corresponding author at: Department of Gastroenterology, Zhongnan Hospital of Wuhan University, 430071 Wuhan, China.Department of Gastroenterology, Zhongnan Hospital of Wuhan UniversityWuhan430071China

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Highlights

Our results also indicated that the prevalence of diarrhoea, nausea/vomiting, and abdominal pain in COVID-19 patients was 9.1%, 5.2%, and 3.5%, respectively.
We found that 0.8-11% of COVID-19 patients had chronic liver comorbidities and 2.6-53% patients had abnormal levels of ALT, AST and TB, and 6-98% had abnormal levels of ALB during the COVID-19 progression.
Meanwhile, diarrhea and nausea/vomiting were not associated with the COVID-19 progression and patient prognosis.

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Summary

Backgrounds

Since December 2019, novel coronavirus (SARS-CoV-2)-infected pneumonia (COVID-19) occurred in Wuhan, and rapidly spread throughout China. Our study aimed to evaluate the association of liver injury and gastrointestinal symptoms (GIS) with the progression of COVID-19.

Methods

A comprehensive search was performed on the PubMed to identify eligible studies that summarized the liver injury and GIS in COVID-19.

Results

A total of 21 studies with 3024 patients were included. Up to 53% patients had liver dysfunctions and the degree of liver damage was associated the severity of the disease. The prevalence of diarrhoea, nausea/vomiting or abdominal pain in patients with COVID-19 were 9.1%, 5.2% and 3.5%, respectively. No significant was found in the prevalence of diarrhoea (OR, 1.24; 95%CI, 0.90 to 1.72; I2=0%, P=0.19) and nausea/vomiting (OR, 1.24; 95%CI, 0.57 to 2.69; I2=61%, P=0.58) between severe and non-severe patients. In addition, diarrhoea (OR, 1.22; 95%CI, 0.50 to 2.98; I2=0%, P=0.66) and nausea/vomiting (OR, 1.09; 95%CI, 0.46 to 2.62; I2=0%, P=0.84) were not associated with the prognosis of COVID-19 patients.

Conclusions

The incidences of GIS in patients with COVID-19 is relatively low and are not associated with the COVID-19 progression. Gastroenterologists should pay more attention to the liver injury induced by SARS-CoV-2 during the course of infection.

El texto completo de este artículo está disponible en PDF.

Keywords : COVID-19, SARS-CoV-2, Liver injury, Diarrhoea, Gastrointestinal symptoms


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Vol 44 - N° 5

P. 653-661 - octobre 2020 Regresar al número
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