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Correlation between gastrointestinal symptoms and disease severity in patients with COVID-19: a systematic review and meta-analysis
  1. Jing Liu,
  2. Min Cui,
  3. Tao Yang,
  4. Ping Yao
  1. Gastroenterology, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang, China
  1. Correspondence to Dr Ping Yao; 15757826085{at}


Objective To study the correlation between gastrointestinal (GI) symptoms and disease severity in patients with COVID-19.

Design We searched six databases including three Chinese and three English databases for all the published articles on COVID-19. Studies were screened according to inclusion and exclusion criteria. The relevant data were extracted and all the statistical analyses were performed using Revman5.3.

Result In a meta-analysis of 9 studies, comprising 3022 patients, 479 patients (13.7%, 95% CI 0.125 to 0.149) had severe disease and 624 patients (14.7%, 95% CI 0.136 to 0.159) had GI symptoms. Of 624 patients with GI symptoms, 118 patients had severe disease (20.5%, 95% CI 0.133 to 0.276) and of 2397 cases without GI symptoms, 361 patients had severe disease (18.2%, 95% CI 0.129 to 0.235). Comparing disease severity of patients with and without GI symptoms, the results indicated: I²=62%, OR=1.21, 95% CI 0.94 to 1.56, p=0.13; there was no statistically significant difference between the two groups. The funnel plot was symmetrical with no publication bias.

Conclusion Current results are not sufficient to demonstrate a significant correlation between GI symptoms and disease severity in patients with COVID-19.

  • gastrointestinal function
  • diarrhoea
  • gastric function

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  • Contributors JL designed the study, analysed the data and wrote the paper. MC and TY collected data and performed the study. PY designed the study, supervised the whole study process and critically revised the manuscript.

  • Funding This study was funded by National Science Funding of China (81760100).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.