■这项研究的目的是通过定量评估恶心等胃肠道症状的患病率,系统分析和总结COVID-19对消化系统的影响,呕吐,腹痛,便秘,腹泻,厌食症.报告COVID-19病例。我们同时调查了其他变量,以确定COVID-19患者中此类症状的相关性,这些症状可能会影响疾病的预后和结局。本系统综述提供了有关该问题的最新文献,因为它需要更多的科学讨论,以便更好地告知医学界和当局,以便可以采取适当措施来控制病毒爆发。
■搜索MEDLINE数据库以识别相关文章。对16项合格研究的数据进行了分析和合成,这些研究专门报道了COVID-19患者的胃肠道症状以及疾病预后。对具有与其他相关独立变量相关的特定胃肠道症状患病率的足够信息的研究进行了荟萃分析。
■从搜索策略来看,我们确定了16篇符合我们资格标准的文章,包括10项横断面研究,2队列研究,1项RCT和3项观察性研究。从这些汇集的研究中,6篇文章专门讨论了COVID-19患者的胃肠道症状,并进行了充分的讨论。在总共3646名患者中,(16.2%-10.1%)患者出现胃肠道症状。最常见的胃肠道症状是腹泻(47%),但最常见的临床表现是发热(77.4%)。在成年患者中,高血压(11.6%)是最常见的合并症.在具有GI症状的16.7%的患者中注意到粪便样品中存在病毒RNA。在抱怨有胃肠道症状的患者中,在很大程度上观察到肝功能异常,ALT水平升高(10.9%)和AST升高(8.8%)的患者。在一项研究中报告了垂直传播的证据(14.2%),该研究强调了病毒传播的程度和模式。据观察,在6项专门报告有胃肠道症状的患者的研究中,绝大多数患者接受抗病毒治疗(68.6%)作为标准疾病管理方案,但最终的疾病结局在这种情况下死亡(8.4%)。出院(45.6%)并不只与一个治疗因素相关,但其他疾病严重程度指标如胸部CT阳性(87.82%)导致疾病预后不良,与有胃肠道症状的非严重COVID-19患者(71.1%)相比,有胃肠道症状的严重患者(28.9%)出现疾病预后不良.
COVID-19患者中胃肠道症状的存在与可能是直接病毒毒性导致的不良疾病预后呈正相关。医生必须认识到消化症状是COVID-19患者的重要特征。因此,应进行准确和有针对性的胃肠道症状记录和病毒性粪便样本调查,以了解快速演变的疾病症状学.
UNASSIGNED: The aim of this study is to systematically analyze and summarize the implications of COVID-19 on the digestive system by quantitatively evaluating the prevalence of gastrointestinal symptoms such as nausea, vomiting, abdominal pain, constipation, diarrhea, anorexia. reported in COVID-19 cases. We simultaneously investigated other variables to determine the association of such symptoms in COVID-19 patients which can potentially influence the disease prognosis and outcome. This systematic
review presents an updated literature on the issue as it requires more scientific discussion in order to better inform the medical community and authorities so that appropriate measures can be taken to control the virus outbreak.
UNASSIGNED: MEDLINE database was searched to identify relevant articles. Data was analyzed and synthesized from the 16 eligible studies which exclusively reported GI symptoms in COVID-19 patients along with the disease prognosis. A meta-analysis of studies having adequate information regarding the prevalence of specific GI symptoms in association with other relevant independent variables was performed.
UNASSIGNED: From the search strategy, we identified 16 articles which fit our eligibility criteria comprising of 10 cross-sectional studies, 2 cohort study, 1 RCT and 3 observational studies. From these pooled studies, 6 articles exclusively talked about COVID-19 patients in which GI symptoms were reported and adequately discussed. In a total of 3646 patients, GI symptoms were documented in (16.2%-10.1%) patients. The most prevalent GI symptom was diarrhea (47%) but the most common clinical manifestation reported was fever (77.4%). Among the adult patients, hypertension (11.6%) was the most frequently reported comorbidity. Presence of viral RNA in stool sample was noted in 16.7% patients with GI symptom. In patients who complained of having GI symptoms, an abnormal liver function was largely observed, with an elevated ALT level in (10.9%) and an elevated AST in (8.8%) of the patients. Evidence of vertical transmission (14.2%) was reported in one study which highlights the extent and mode of viral transmission. It was observed that a great majority of the patients in the 6 studies reporting specifically on patients with GI symptoms were on antiviral therapy (68.6%) as the standard disease management protocol but the eventual disease outcome as in this case died (8.4%), discharged (45.6%) was not linked to just one therapeutic factor but other indicators of disease severity such as positive chest CT findings (87.82%) have led to a poor disease prognosis which was noted in (28.9%) severe patients with GI symptoms compared to (71.1%) non-severe COVID-19 patients with GI symptom.
UNASSIGNED: Presence of GI symptoms in COVID-19 patients has shown to have a positive association with the poor disease prognosis likely as a result of direct viral toxicity. It is important for the physicians to recognize digestive symptoms as an important characteristic in COVID-19 patients. Hence, precise and targeted documentation of GI symptoms and viral stool sample investigations should be performed in order to understand the rapidly evolving disease symptomology.