gastrointestinal manifestations of the covid-19: a systematic review and meta-analysis with 111 studies

Introduction: since the start of a pandemic from wuhan, china in 2019, there is tremendous attention on the covid-19 manifestation. one of the most important covid-19 clinical presentations is gastrointestinal symptoms. the current systematic review study aims to focus on the implication of the gastrointestinal tract in patients infected with sars-cov-2. methods: we searched literature in medline, scopus, web of science, and embase to find related article by using the following keywords covid-19, sars-cov-2 infection, gastrointestinal tract, digestive system. the heterogeneity of included studies was quantified with the i2 statistic. a random-effects model was used to estimate the pooled prevalence and a meta-regression method was utilized to investigate the factors affecting heterogeneity between studies. results: of 3028 retrieved documents, 111 studies with 21126 covid-19 cases were included. the prevalence of any gastrointestinal symptoms was 17.22% (14.48 to 20.13). the prevalence of diarrhea was 13.75% (12.07 to 15.44), anorexia 27.41% (21.53 to 33.29) and nausea/vomiting 8.11% (6.87 to 9.35). furthermore, the prevalence of other symptoms in current study was fever 76.70% (73.42 to 79.83), cough 58.07% (54.59 to 61.52) and dyspnea/shortness of breath 24.63% (20.06 to 29.48). according to meta-regression results, age (p: 0.027) and fever (p<0.001) had significant effect on prevalence of any gastrointestinal symptoms. conclusion: the anorexia, diarrhea, nausea, and vomiting are the most common gastrointestinal presentations.