Gastrointestinal Manifestations of the COVID-19: A Systematic Review and Meta-Analysis with 111 studies

Introduction/aims: Since the start of a pandemic from Wuhan, China in 2019, there is tremendous attention in the COVID-19 manifestation. One of the most important COVID-19 clinical presentations is gastrointestinal symptoms. The current systematic review study aims to focus on the implication of the gastrointestinal tract in patients infected with SARS-CoV-2. Methods: For that we searched literature in MEDLINE, Scopus, Web of Science, and Embase. Also, the medRxiv was searched for preprints. The search was performed by using the following keywords "Covid-19", "Coronavirus", "SARS-CoV-2 infection", "SARS-CoV-2", "Gastrointestinal", "Gastrointestinal Tract", "digestive system". All the studies were conducted based on the PRISMA criteria. Results: Of 3028 retrieved documents, 111 studies with 21126 COVID-19 cases were included. The prevalence of any Gastrointestinal symptoms was 17.22% (14.48 to 20.13). The prevalence of diarrhea was 13.75% (12.07 to 15.44), anorexia 27.41% (21.53 to 33.29) and Nausea/vomiting 8.11% (6.87 to 9.35). Furthermore, the prevalence of other symptoms in our current study was fever 76.70% (73.42 to 79.83), cough 58.07% (54.59 to 61.52) and dyspnea/shortness of breath 24.63% (20.06 to 29.48). According to meta-regression results, age (p: 0.027) and fever (p