Digestive system symptoms and function in children with COVID-19: A meta-analysis

The prevalence of children exhibiting coronavirus disease 2019 (COVID-19) with digestive system involvement remains unknown. Therefore, we aimed to quantify the impact of COVID-19 on the digestive system of children. In this meta-analysis, we searched PubMed, Embase, and Web of Science from January 1, 2020, to June 31, 2020. We also searched for COVID-19 publications in specific journals for more comprehensive results. We included studies that reported the epidemiological and clinical characteristics of COVID-19, and we excluded duplicate publications, reviews, animal studies, case reports, publications without the full text, studies with incomplete information, and studies from which data extraction was impossible. We conducted a meta-analysis of the incidence of gastrointestinal symptoms and changes in liver function involving 19 studies. The pooled prevalence of diarrhea was 10% (95% CI: 7–14; I(2) = 84%), that of nausea or vomiting was 7% (95% CI: 5–11; I(2) = 77%), and that of abdominal pain was 4% (95% CI: 2–9; I(2) = 79%). In addition, the pooled incidence of increased alanine aminotransferase was 8% (95% CI: 5–15; I(2) = 46%), and the pooled incidence of increased AST was 15% (95% CI: 9–26; I(2) = 66%). The pooled rate of recovery was 97% (95% CI: 94–100; I(2) = 86%), and the pooled rate of death, which was 1% (95% CI: 1–4; I(2) = 48%), was much smaller than the recovery rate. Our research shows that digestive system symptoms and function in children with COVID-19 are not uncommon. More attention should be paid to this unique group of patients.