Severity of COVID-19 in Patients with Diarrhoea: A Systematic Review and Meta-Analysis

Sunita Dhakal; Pimphen Charoen; Wirichada Pan-Ngum; Viravarn Luvira; Chaisith Sivakorn; Borimas Hanboonkunupakarn; Sakkarin Chirapongsathorn; Kittiyod Poovorawan

doi:10.3390/tropicalmed8020084

Severity of COVID-19 in Patients with Diarrhoea: A Systematic Review and Meta-Analysis

Trop Med Infect Dis. 2023 Jan 26;8(2):84. doi: 10.3390/tropicalmed8020084.

Authors

Sunita Dhakal¹, Pimphen Charoen², Wirichada Pan-Ngum², Viravarn Luvira¹, Chaisith Sivakorn¹, Borimas Hanboonkunupakarn¹, Sakkarin Chirapongsathorn³, Kittiyod Poovorawan¹

Affiliations

¹ Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
² Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
³ Department of Gastroenterology and Hepatology, Phramongkutklao Hospital, College of Medicine, Bangkok 10400, Thailand.

Abstract

COVID-19 patients occasionally present with diarrhoea. Our objective was to estimate the risk of developing the severe disease in COVID-19 patients with and without diarrhoea and to provide a more precise estimate of the prevalence of COVID-19-associated digestive symptoms. A total of 88 studies (n = 67,794) on patients with a COVID-19 infection published between 1 January 2020 and 20 October 2022 were included in this meta-analysis. The overall prevalence of digestive symptoms was 27% (95% confidence interval (CI): 21-34%; I² = 99%). According to our data, the pooled prevalence of diarrhoea symptoms in the 88 studies analysed was 17% (95% CI: 14-20%; I² = 98%). The pooled estimate of nausea or vomiting in a total of 60 studies was 12% (95% CI: 8-15%; I² = 98%). We also analysed 23 studies with eligible individuals (n = 3800) to assess the association between the disease severity and diarrhoea. Individuals who had diarrhoea were more likely to have experienced severe COVID-19 (odds ratio: 1.71; 95% CI: 1.31-2.24; p < 0.0001; I² = 10%). Gastrointestinal symptoms and diarrhoea are frequently presenting COVID-19 manifestations that physicians should be aware of.

Keywords: SARS-CoV-2; abdominal pain; anorexia; diarrhoea; gastrointestinal tract; nCoV COVID-19; nausea; vomiting.

Publication types

Review

Grants and funding

The study was funded by the Faculty of Tropical Medicine of Mahidol University. The funders had no role in the study’s design, data collection and interpretation, publication or manuscript writing.