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GI Symptoms Seen in Less Than 10 Percent of COVID-19 Patients

Outpatients with new-onset GI symptoms should be monitored for COVID-19 symptoms

THURSDAY, May 7, 2020 (HealthDay News) -- Gastrointestinal (GI) symptoms are seen in less than 10 percent of patients with COVID-19, according to a meta-analysis published online May 4 in Gastroenterology.

Shahnaz Sultan, M.D., from the University of Minnesota in Minneapolis, and colleagues performed a systematic literature search to identify studies describing data on GI and liver manifestations of COVID-19. The prevalence of diarrhea, nausea, vomiting, and abdominal pain was analyzed, in addition to liver function test (LFT) abnormalities.

A meta-analysis was performed of 47 studies with 10,890 unique patients; most of the studies involved hospitalized patients. The researchers found that the pooled prevalence estimates for GI symptoms were 7.7, 7.8, and 2.7 percent for diarrhea, nausea/vomiting, and abdominal pain, respectively. The pooled prevalence of elevated liver abnormalities was 15.0 and 15.0 percent for both aspartate transaminase and alanine transaminase, respectively. Diarrhea, nausea/vomiting, and liver abnormalities were more prevalent in countries outside of China, with diarrhea reported in 18.3 percent of patients. Reports of isolated GI symptoms were rare.

Based on these findings, the authors recommend ascertaining information about high-risk contact exposure and a detailed history of COVID-19 symptoms in outpatients with new-onset diarrhea. Outpatients with new-onset GI symptoms should be monitored for COVID-19-associated symptoms because GI symptoms can precede COVID-19-related symptoms. COVID-19 testing should be considered in settings of high COVID-19 prevalence. A thorough history of GI symptoms should be obtained in hospitalized patients with suspected or confirmed COVID-19. Baseline LFTs should be obtained at the time of admission in hospitalized patients with suspected or confirmed COVID-19.

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