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
March 30, 2022
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Key Question
Does COVID-19 affect your digestive system?
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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
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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...
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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 ...
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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...
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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 ...
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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.