COVID Paper Database
Visual Abstract
Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From a Hong Kong Cohort: Systematic Review and Meta-analysis
Ka Shing Cheung , Ivan F N Hung , Pierre P Y Chan , K C Lung , Eugene Tso , Raymond Liu , Y Y Ng , Man Y Chu , Tom W H Chung , Anthony Raymond Tam , Cyril C Y Yip , Kit-Hang Leung , Agnes Yim-Fong Fung , Ricky R Zhang , Yansheng Lin , Ho Ming Cheng , Anna J X Zhang , Kelvin K W To , Kwok-H Chan , Kwok-Y Yuen , Wai K Leung
Reviewed by Charles Li, MD
š¤
Key Question
Does COVID-19 affect your digestive system?
ā
Yes, and it causes symptoms
A meta-analysis found that patients often do have COVID-19 viral particles in their fecal samples. It can cause diarrhea in some patients.
Visual Abstract
Click to expand
Background
It's pretty well known that COVID-19 can cause you to cough, get a runny nose, and feel short of breath. COVID-19 can also in some cases cause diarrhea.
Based on this, researchers wanted to see just how COVID-19 affected the digestive system and whether we can detect COVID-19 in your poop.
Study Quote
Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), which has been characterized by fever, respiratory, and gastrointestinal symptoms as well as shedding of virus RNA into feces. We performed a systematic review and meta...
Show More
Methods
Researchers combined data from 60 studies, covering over 4000 patients. They also collected data from 59 patients in Hong Kong to further study the effects of COVID-19 on the digestive system.
Study Quote
We collected data from the cohort of patients with COVID-19 in Hong Kong (N = 59; diagnosis from February 2 through February 29, 2020),and searched PubMed, Embase, Cochrane, and 3 Chinese databases through March 11, 2020, according to the Preferred Reporting Items for Systematic Reviews ...
Show More
Results
They found that overall, 18% of people with COVID-19 reported digestive symptoms. This most commonly came in the form of diarrhea, but could also show itself as nausea, vomiting, and loss of appetite.
18% of those with COVID-19 had digestive symptoms. 48% of patients tested had detectable COVID-19 in their fecal samples.
Around half of the patients had detectable COVID-19 in their stool, or poop, in studies where this was analyzed. This shows that COVID-19 most likely infects your digestive tract and that many of us can shed the virus this way.
70% of those with COVID-19 in their fecal samples were positive in their fecal samples for longer than their respiratory samples.
Patients who do test "positive" for COVID-19 in their fecal samples actually tend to test positive for longer in their fecal samples than their respiratory samples, suggesting that COVID-19 can linger for longer in your digestive tract.
Researchers found that those who have diarrhea are more likely to have COVID-19 positive fecal samples.
Not surprisingly, those who report diarrhea were more likely to have COVID-19 viral particles in their fecal samples than those who did not.
Study Quote
Among the 59 patients with COVID-19 in Hong Kong, 15 patients (25.4%) had gastrointestinal symptoms, and 9 patients (15.3%) had stool that tested positive for virus RNA. Stool viral RNA was detected in 38.5% and 8.7% among those with and without diarrhea, respectively (P = .02). The medi...
Show More
Conclusions
Based on the data in this study, researchers concluded that COVID-19 can affect your digestive system, causing diarrhea in some patients. Patients who have COVID-19 may be shedding viral particles in their feces.
Healthcare workers in particular should be careful in handling fecal samples from COVID-19 patients since these could be infectious.
Study Quote
In an analysis of data from the Hong Kong cohort of patients with COVID-19 and a meta-analysis of findings from publications, we found that 17.6% of patients with COVID-19 had gastrointestinal symptoms. Virus RNA was detected in stool samples from 48.1% patients, even in stool collected ...
Show More
Visual Abstract
COVID-19 viral particles can be found in fecal samples, suggesting that it can infect the digestive tract. A meta-analysis found that 18% of COVID-19 patients reported digestive symptoms such as diarrhea. Many more had detectable COVID-19 RNA in their fecal samples. Those with diarrhea are more likely to shed COVID-19 in their feces.