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

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; I(2) = 0%, P = 0.19) and nausea/vomiting (OR, 1.24; 95%CI, 0.57 to 2.69; I(2) = 61%, P = 0.58) between severe and non-severe patients. In addition, diarrhoea (OR, 1.22; 95%CI, 0.50 to 2.98; I(2) = 0%, P = 0.66) and nausea/vomiting (OR, 1.09; 95%CI, 0.46 to 2.62; I(2) = 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.