Salivirus infection: Systematic review and meta‐analysis of association with gastrointestinal symptoms in children

The novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection has been predominantly linked to respiratory distress syndrome, but gastrointestinal symptoms and hepatic injury have also been reported. The mechanism of liver injury is poorly understood and may result as a consequence of viral hepatitis, systemic inflammatory response, gut barrier and microbiome alterations, intensive care treatment or drug toxicity. The incidence of hepatopathy among patients with coronavirus disease 2019 (COVID-19) is unclear, but studies have reported liver injury in patients with SARS and Middle East respiratory syndrome (MERS). We aimed to systematically review data on the prevalence of hepatic impairments and their clinical course in SARS and MERS Coronaviridae infections. A systematic literature search (PubMed/Embase/Cinahl/Web of Science) according to preferred reporting items for systematic review and meta-analysis protocols (PRISMA) was conducted from database inception until 17/03/2020 for studies that evaluated the incidence of hepatic abnormalities in SARS CoV-1, SARS CoV-2 and MERS infected patients with reported liver-related parameters. A total of forty-three studies were included. Liver anomalies were predominantly mild to moderately elevated transaminases, hypoalbuminemia and prolongation of prothrombin time. Histopathology varied between non-specific inflammation, mild steatosis, congestion and massive necrosis. More studies to elucidate the mechanism and importance of liver injury on the clinical course and prognosis in patients with novel SARS-CoV-2 infection are warranted.

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S1260 Do New Gastrointestinal Symptoms Warrant COVID-19 Testing? A Systematic Review and Meta-Analysis

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000707088.49654.86 ◽

2020 ◽

Vol 115 (1) ◽

pp. S632-S633

Author(s):

Robert Dorrell ◽

Michael K. Dougherty ◽

Eric Barash ◽

Asher Lichtig ◽

Elizabeth Jensen ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Gastrointestinal Symptoms

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COVID-19 Associated Multisystem Inflammatory Syndrome: A Systematic Review and Meta-analysis

Iranian Journal of Allergy Asthma and Immunology ◽

10.18502/ijaai.v19i6.4927 ◽

2020 ◽

Author(s):

Ashkan Baradaran ◽

Abdolreza Malek ◽

Nasrin Moazzen ◽

Zahra Abbasi Shaye

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Gastrointestinal Symptoms ◽

Multiple Organ ◽

Current Evidence ◽

Cardiac Complications ◽

Clinical Presentations ◽

Atypical Kawasaki Disease ◽

Novel Coronavirus ◽

Inflammatory Syndrome

The prevalence of multisystem inflammatory syndrome in children (MIS-C) has increased since the coronavirus disease 2019 (COVID-19) pandemic started. This study was aimed to describe clinical manifestation and outcomes of MIS-C associated with COVID-19. This systematic review and meta-analysis were conducted on all available literature until July 3rd, 2020. The screening was done by using the following keywords: (“novel coronavirus” Or COVID-19 or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus) and ("MIS-C" or "multisystem inflammatory" or Kawasaki). Data on gender, ethnicity, clinical presentations, need for mechanical ventilation or admission to intensive care unit (ICU), imaging, cardiac complications, and COVID-19 laboratory results were extracted to measure the pooled estimates. Out of 314 found articles, 16 articles with a total of 600 patients were included in the study, the most common presentation was fever (97%), followed by gastrointestinal symptoms (80%), and skin rashes (60%) as well as shock (55%), conjunctivitis (54%), and respiratory symptoms (39%). Less common presentations were neurologic problems (33%), and skin desquamation (30%), MIS-C was slightly more prevalent in males (53.7%) compared to females (46.3%). The findings of this meta-analysis on current evidence found that the common clinical presentations of COVID-19 associated MIS-C include a combination of fever and mucocutaneous involvements, similar to atypical Kawasaki disease, and multiple organ dysfunction. Due to the relatively higher morbidity and mortality rate, it is very important to diagnose this condition promptly.

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Correction: Association between delayed gastric emptying and upper gastrointestinal symptoms: a systematic review and meta-analysis

Gut ◽

10.1136/gutjnl-2018-316405corr1 ◽

2019 ◽

Vol 68 (10) ◽

pp. 1908-1908

Keyword(s):

Systematic Review ◽

Gastric Emptying ◽

Delayed Gastric Emptying ◽

Meta Analysis ◽

Gastrointestinal Symptoms ◽

Upper Gastrointestinal Symptoms ◽

Upper Gastrointestinal

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Prevalence and Mortality of COVID-19 Patients With Gastrointestinal Symptoms: A Systematic Review and Meta-analysis

Mayo Clinic Proceedings ◽

10.1016/j.mayocp.2020.06.003 ◽

2020 ◽

Vol 95 (8) ◽

pp. 1632-1648 ◽

Cited By ~ 4

Author(s):

Raseen Tariq ◽

Srishti Saha ◽

Fateeha Furqan ◽

Leslie Hassett ◽

Darrell Pardi ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Gastrointestinal Symptoms

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Gastrointestinal manifestations of COVID-19 in children: a systematic review and meta-analysis

Frontline Gastroenterology ◽

10.1136/flgastro-2020-101529 ◽

2020 ◽

pp. flgastro-2020-101529 ◽

Cited By ~ 1

Author(s):

Anthony K Akobeng ◽

Ciaran Grafton-Clarke ◽

Ibtihal Abdelgadir ◽

Erica Twum-Barimah ◽

Morris Gordon

Keyword(s):

Systematic Review ◽

English Language ◽

Case Reports ◽

Meta Analysis ◽

Gastrointestinal Symptoms ◽

Case Series ◽

Risk Of Bias ◽

Gastrointestinal Manifestations ◽

Published Evidence ◽

Pooled Prevalence

ObjectivesTo summarise the published evidence on the gastrointestinal manifestations of COVID-19 in children and to determine the prevalence of gastrointestinal symptoms.MethodsIn this systematic review and meta-analysis, we searched PubMed, Embase, CINAHL and the WHO’s database of publications on novel coronavirus. We included English language studies that had described original demographic and clinical characteristics of children diagnosed with COVID-19 and reported on the presence or absence of gastrointestinal symptoms. Meta-analysis was conducted using the random-effects model. The pooled prevalence of gastrointestinal symptoms was expressed as proportion and 95% CI.ResultsThe search identified 269 citations. Thirteen studies (nine case series and four case reports) comprising data for 284 patients were included. Overall, we rated four studies as having a low risk of bias, eight studies as moderate and one study as high risk of bias. In a meta-analysis of nine studies, comprising 280 patients, the pooled prevalence of all gastrointestinal symptoms was 22.8% (95% CI 13.1% to 35.2%; I2=54%). Diarrhoea was the most commonly reported gastrointestinal symptom followed by vomiting and abdominal pain.ConclusionsNearly a quarter of children with COVID-19 have gastrointestinal symptoms. It is important for clinicians to be aware of the gastrointestinal manifestation of COVID-19.PROSPERO registration numberCRD42020177569.

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Azapirone 5-HT1A receptor partial agonist treatment for major depressive disorder: systematic review and meta-analysis

Psychological Medicine ◽

10.1017/s0033291713002857 ◽

2013 ◽

Vol 44 (11) ◽

pp. 2255-2269 ◽

Cited By ~ 9

Author(s):

T. Kishi ◽

H. Y. Meltzer ◽

Y. Matsuda ◽

N. Iwata

Keyword(s):

Systematic Review ◽

Major Depressive Disorder ◽

Side Effects ◽

Depressive Disorder ◽

Partial Agonist ◽

Meta Analysis ◽

Gastrointestinal Symptoms ◽

Cochrane Library ◽

Number Needed To Treat ◽

Major Depressive

BackgroundA meta-analysis of the serotonin1A (5-HT1A) receptor partial agonist of the azapirone class as an anxiolytic drug for the treatment of major depressive disorder (MDD) has not previously been reported.MethodWe carried out a systematic review of the literature available in PubMed, the Cochrane Library database and PsycINFO up to 12 October 2013, and conducted a meta-analysis of randomized controlled trials (RCTs) comparing 5-HT1A agonists with placebo and RCTs of 5-HT1A agonist augmentation therapies for MDD treatment. We calculated the risk ratio (RR), number needed to treat (NNT)/number needed to harm (NNH) and 95% confidence intervals (CIs).ResultsFifteen RCTs comparing 5-HT1A agonists with placebo (total n = 2469, four studies with buspirone, seven with gepirone, three with ipsapirone and one with zalospirone) were identified. Pooled 5-HT1A agonists had significantly more responders (RR 0.74, 95% CI 0.65–083, p < 0.00001, NNT = 6, 12 trials, n = 1816) than placebo. Pooled 5-HT1A agonists were superior to placebo in discontinuation due to inefficacy (RR 0.49, p = 0.02, NNH = 16, p = 0.03, 10 trials, n = 1494) but were inferior to placebo in discontinuation due to side-effects (RR 1.88, p < 0.0001, NNH = 17, p = 0.001, 13 trials, n = 2196). However, all-cause discontinuation was similar in both groups (RR 0.99, p = 0.85, 14 trials, n = 2402). Four 5-HT1A agonist augmentation studies were identified (total n = 365, three buspirone studies and one tandospirone study). There were no statistically significant effects of 5-HT1A agonist augmentation therapies on response rate (RR 0.98, p = 0.85, four trials, n = 341). 5-HT1A agonist-related side-effects including gastrointestinal symptoms, dizziness, insomnia, palpitation, paresthesia and sweating were greater than with placebo (p < 0.00001 to p = 0.03).ConclusionsOur results suggest that 5-HT1A agonist has a more beneficial effect on MDD than placebo, but has several side-effects.

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