Gastrointestinal Symptoms in Patients with COVID-19

Introduction: Though coronavirus disease 2019 (COVID-19) is predominantly a respiratory illness, a growing number of studies reported gastrointestinal (GI) symptoms among these patients. We examined the incidence of GI symptoms in patients with COVID-19 and GI symptoms as the initial presentation of the disease. Methods: We examined peer-reviewed studies in English of patients with COVID-19 that reported GI symptoms. We searched PubMed and Google Scholar for articles published up to June 30, 2020, by using the keywords ``COVID-19,\u27\u27 ``Coronavirus,\u27\u27 ``severe acute respiratory syndrome coronavirus 2,\u27\u27, ``SARS-CoV-2,\u27\u27 ``gastrointestinal tract,\u27\u27 ``gastrointestinal diseases,\u27\u27 and ``gastrointestinal symptoms and signs.\u27\u27 Studies with fewer than 30 patients and also those studies that did not report nausea, vomiting, and diarrhea were excluded. Results: We reviewed 26 studies that reported GI symptoms among patients with COVID-19. Twenty-three studies were from China, and the three remaining studies were from three different countries: the US, France, and South Korea. The mean age of patients was 47.2 years, and 50.3% were females. Out of a total of 7,212 patients, 672 patients had nausea and/or vomiting (8.7%), and 732 (9.5%) had diarrhea; 6.8% of patients had GI symptoms as the initial presentation of COVID-19. Conclusion: GI symptoms are not common in COVID-19 patients. However, the recognition of GI symptoms may significantly help in implementing steps to prevent SARS-CoV-2 transmission. Testing for COVID-19 in patients presenting with only GI symptoms may help detect and prevent the spread of COVID-19