Diarrhea Is Associated with Increased Severity of Disease in COVID-19: Systemic Review and Metaanalysis

Ghimire, Subash; Sharma, Sachit; Patel, Achint; Budhathoki, Rasmita; Chakinala, Raja Chandra; Khan, Hafiz; Lincoln, Matthew; Georgeston, Michael

doi:10.1007/s42399-020-00662-w

Cited by 32 publications

(25 citation statements)

References 60 publications

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“…Some research proposed that a lack of respiratory support may cause this situation [90]. In addition, patients with diarrhoea were more likely to have severe disease; to some extent, faecal-oral transmission may result in an increasingly heavy load of the virus that exacerbates the symptoms of the illness [91]. Aggarwal et al found that pre-existing cardiovascular diseases were associated with worse outcomes among patients with COVID-19.…”

Section: Discussionmentioning

confidence: 99%

The Severity of COVID-19 and Its Determinants: A Systematic Review and Meta-Analysis in China

et al. 2021

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To analyse the prevalence of severe and critical COVID-19 cases and its determinants, a systematic review and meta-analysis were conducted using Review Manager. Four English and two Chinese databases were used to identify and explore the relationships between the severity of COVID-19 and its determinants, with no restrictions on publication date. The odds ratio and 95% CI were combined to assess the influencing level of all factors. Twenty-three articles containing a total of 15,828 cases of COVID-19 were included in this systematic review. The prevalence of severe and critical COVID-19 cases was 17.84% and 4.9%, respectively. A total of 148 factors were identified, which included behavioural, symptom, comorbidity, laboratory, radiographic, exposure, and other factors. Among them, 35 factors could be included in the meta-analysis. Specifically, for example, the male (OR 1.55, 95% CI 1.42–1.69) and elderly (OR 1.06, 95% CI 1.03–1.10) populations tended to experience severe and critical illness. Patients with cough, dyspnea, fatigue, fever, and gastrointestinal symptoms could have severe and critical diseases. Regarding laboratory results, albumin, aspartate aminotransferase, creatinine, D-dimer, fibrinogen, neutrophils, procalcitonin, platelets, and respiratory rate were potential factors that could be used to predict the severity of COVID.

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Section: Discussionmentioning

confidence: 99%

The Severity of COVID-19 and Its Determinants: A Systematic Review and Meta-Analysis in China

et al. 2021

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“…In a systematic review and meta-analysis, 15.47% of patients had at least one gastrointestinal symptom. 13 The sensitivity and specificity of the ANN model in this study were 94.5% and 17.4%, respectively. In other words, about 95% of patients with COVID-19 were identified by home monitoring using this ANN model.…”

Section: Discussionmentioning

confidence: 52%

COVID-19 screening: use of an artificial neural network

Roustaei

Allahyari

2021

BMJ Support Palliat Care

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ObjectivesCOVID-19 is the biggest pandemic of the 21st century. The disease can be influenced by various sociodemographic factors and can manifest as clinical, pulmonary and gastrointestinal symptoms. This study used an artificial neural network (ANN) model with important sociodemographic factors as well as clinical, pulmonary and gastrointestinal symptoms to screen patients for COVID-19. Patients themselves can screen for these symptoms at home.MethodsData on all registered patients were extracted in autumn. The best ANN model was selected from different combinations of connections, some hidden layers and some neurons in each hidden layer. In this study, 70% of the data were used in the network training process and the remaining 30% were used to evaluate the function of the multilayer, feed-forward, back-propagation algorithm.ResultsThe sensitivity and specificity of the ANN model in diagnosing patients with COVID-19 were 94.5% and 17.4%. In order of priority, clinical symptoms, sociodemographic factors, pulmonary symptoms and gastrointestinal symptoms were important predictive factors for COVID-19 using the ANN model. Screening patients for COVID-19 using clinical symptoms and sociodemographic factors (80% importance) remains essential.ConclusionsHome monitoring of oxygen saturation and body temperature as well as old age and drug addiction can be helpful in self-screening symptoms of COVID-19 at home, thereby preventing unnecessary visits to medical centres and reducing burden on medical services.

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“…Nonetheless, the results of a meta-analysis of the prevalence and mortality of COVID-19 patients with gastrointestinal symptoms indicate that the mortality among patients with gastrointestinal symptoms is similar to the overall mortality [ 20 ]. Another meta-analysis found conflicting results and reported that diarrhea is associated with increased severity of disease for COVID-19 [ 21 ]. Since this meta-analysis data was obtained from patients of countries presenting a high level of sanitation, it is likely that in most cases, the initial site of infection of COVID-19 patients was the respiratory system and that the infection of the digestive system was a secondary event and therefore may not contribute to lowering the severity of the disease.…”

Section: Discussionmentioning

confidence: 99%

Does Fecal-Oral Transmission of SARS-CoV-2 Due to Low Sanitation Conditions Contribute to Low Mortality Rates From COVID-19

Rothschild¹

2021

Cureus

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Background: The novel coronavirus disease 2019 (COVID-19) is a global pandemic generated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The primary infection site is mucosal surfaces, mainly the lungs and the intestine, where epithelial cells can be infected. COVID-19 has spread throughout the world, causing millions of deaths and hundreds of millions of confirmed infections. Despite the global spread of SARS-CoV-2, there are extreme differences between countries in mortality rates and confirmed infections.Methods: Pearson correlations and a t-test were performed on data from 137 countries in order to test the correlation between number of deaths from diarrheal diseases (pre-COVID-19 pandemic data) as a marker for countries' sanitation level, and the number of confirmed COVID-19 cases and deaths per million.Results: It was found that countries' prevalence of confirmed COVID-19 cases and deaths per million are statistically correlated with their sanitation level.Conclusions: The hypothesis proposed in this article is that the low mortality rates from COVID-19 in countries where the level of sanitation is low are due to fecal-oral infection of the population by SARS-CoV-2, rather than infection of the respiratory system. This hypothesis is supported by the protective effect of the low sanitation level presented in this work and the fact that lung infection by SARS-CoV-2 can cause severe pathology, while infection in the intestine generally causes minor or no symptoms.

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Diarrhea Is Associated with Increased Severity of Disease in COVID-19: Systemic Review and Metaanalysis

Cited by 32 publications

References 60 publications

The Severity of COVID-19 and Its Determinants: A Systematic Review and Meta-Analysis in China

The Severity of COVID-19 and Its Determinants: A Systematic Review and Meta-Analysis in China

COVID-19 screening: use of an artificial neural network

Does Fecal-Oral Transmission of SARS-CoV-2 Due to Low Sanitation Conditions Contribute to Low Mortality Rates From COVID-19

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