SynthesisBMJ open gastroenterology2021
Gastroenterological and hepatic manifestations of patients with COVID-19, prevalence, mortality by country, and intensive care admission rate: systematic review and meta-analysis.
Synthesis in BMJ open gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.
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Who cites it
44 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clinical manifestations of COVID-19: An overview of 102 systematic reviews with evidence mapping.Journal of evidence-based medicine · 2022Pooled it
- Impact of medical therapies for inflammatory bowel disease on the severity of COVID-19: a systematic review and meta-analysis.BMJ open gastroenterology · 2021Pooled it
- Gastrointestinal Symptoms and Abnormal Liver Biochemistry in Patients with COVID-19 Pneumonia Admitted to the Department of Gastroenterology After Ending Zero-COVID Policy in China.Advances in therapy · 2026Article
- Gastrointestinal and hepatic manifestations among hospitalized COVID-19 children.BMC pediatrics · 2025Article
- Impact of Hepatic Dysfunction on Mortality among Coronavirus Disease 2019 Patients: An Inhospital Observational Study.Annals of African medicine · 2025Article
- A pro-inflammatory gut mucosal cytokine response is associated with mild COVID-19 disease and superior induction of serum antibodies.Mucosal immunology · 2024Article
- Gastrointestinal and Hepatological Manifestations in Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Results from the Major COVID Hospital in Serbia.Microorganisms · 2023Article
- Effects of COVID-19 on the Liver and Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta and Non-Delta Variants: An Analysis in a Single Centre.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Gastrointestinal Manifestations and Outcomes of COVID-19: A Comprehensive Systematic Review and Meta-analysis.Cureus · 2023Review
- COVID-19 and Gastrointestinal Tract: From Pathophysiology to Clinical Manifestations.Medicina (Kaunas, Lithuania) · 2023Review
- Liver Involvement during SARS-CoV-2 Infection Is Associated with a Worse Respiratory Outcome in COVID-19 Patients.Viruses · 2023Article
- COVID-19 Infection and Vaccination and Its Relation to Amyloidosis: What Do We Know Currently?Vaccines · 2023Review
- Intestinal barrier dysfunction as a key driver of severe COVID-19.World journal of virology · 2023Review
- Are Gastrointestinal Symptoms Important in Patients with COVID-19?The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2023Article
- Diarrhea and Coronavirus Disease 2019 Infection.Gastroenterology clinics of North America · 2023Review
- Gastrointestinal Endoscopy in Patients with Coronavirus Disease 2019: Indications, Findings, and Safety.Gastroenterology clinics of North America · 2023Review
- COVID-19: gastrointestinal and hepatobiliary manifestations.Human pathology · 2023Review
- Prevention, diagnostic evaluation, management and prognostic implications of liver disease in critically ill patients with COVID-19.World journal of clinical cases · 2023Review
- Impact of baseline abnormal liver enzymes in the outcome of COVID-19 infection.Translational gastroenterology and hepatology · 2023Article
- Understanding clinical characteristics influencing adverse outcomes of Omicron infection: a retrospective study with propensity score matching from a Fangcang hospital.Frontiers in cellular and infection microbiology · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsPatients infected with the SARS-CoV-2 usually report fever and respiratory symptoms. However, multiple gastrointestinal (GI) manifestations such as diarrhoea and abdominal pain have been described. The aim of this study was to evaluate the prevalence of GI symptoms, elevated liver enzymes and mortality of patients with COVID-19.
methodsA systematic review and meta-analysis of published studies that included a cohort of patients infected with SARS-CoV-2 were performed from 1 December 2019 to 15 December 2020. Data were collected by conducting a literature search using PubMed, Embase, Scopus, and Cochrane according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We analysed pooled data on the prevalence of individual GI symptoms and elevated liver enzymes and performed subanalyses to investigate the relationship between GI symptoms/elevated liver enzymes, geographical location, mortality, and intensive care unit (ICU) admission.
resultsThe available data of 78 798 patients positive for SARS-CoV-2 from 158 studies were included in our analysis. The most frequent manifestations were diarrhoea (16.5%, 95% CI 14.2% to 18.4%), nausea (9.7%, 95% CI 9.0% to 13.2%) and elevated liver enzymes (5.6%, 95% CI 4.2% to 9.1%). The overall mortality and GI mortality were 23.5% (95% CI 21.2% to 26.1%) and 3.5% (95% CI 3.1% to 6.2%), respectively. Subgroup analysis showed non-statistically significant associations between GI symptoms/elevated liver enzymes and ICU admissions (OR=1.01, 95% CI 0.55 to 1.83). The GI mortality was 0.9% (95% CI 0.5% to 2.2%) in China and 10.8% (95% CI 7.8% to 11.3%) in the USA.
conclusionGI symptoms/elevated liver enzymes are common in patients with COVID-19. Our subanalyses showed that the presence of GI symptoms/elevated liver enzymes does not appear to affect mortality or ICU admission rate. Furthermore, the proportion of GI mortality among patients infected with SARS-CoV-2 varied based on geographical location.
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