Goyal, HemantAdler, Douglas G.Nawras, AliHaghbin, HosseinAziz, MuhammadLee-Smith, WadeBackground COVID-19 pandemic has created a need to identify potential predictors of severe disease. We performed a systematic review and meta-analysis of gastrointestinal predictors of severe COVID-19. Methods An extensive literature search was performed using PubMed, Embase, Web of Science and Cochrane. Odds ratio (OR) and mean difference (MD) were calculated for proportional and continuous outcomes using a random-effect model. For each outcome, a 95% confidence interval (CI) and P-value were generated. Results A total of 83 studies (26912 patients, mean age 43.5±16.4 years, 48.2% female) were included. Gastrointestinal predictors of severe COVID-19 included the presence of diarrhea (OR 1.50, 95%CI 1.10-2.03; P=0.01), elevated serum aspartate aminotransferase (AST) (OR 4.00, 95%CI 3.02-5.28; P<0.001), and elevated serum alanine aminotransferase (ALT) (OR 2.54, 95%CI 1.91-3.37; P<0.001). Significantly higher levels of mean AST (MD 14.78 U/L, 95%CI 11.70-17.86 U/L; P<0.001), ALT (MD 11.87 U/L, 95%CI 9.23-14.52 U/L; P<0.001), and total bilirubin (MD 2.08 mmol/L, 95%CI 1.36-2.80 mmol/L; P<0.001) were observed in the severe COVID-19 group compared to non-severe COVID-19 group. Conclusion Gastrointestinal symptoms and biomarkers should be assessed early to recognize severe COVID-19. Keywords SARS-CoV-2, COVID-19, diarrhea, severe COVID-19, predictors Ann Gastroenterol 2020; 33 (6): 615-630text/htmlapplication/pdfhttp://www.annalsgastro.gr/index.php/annalsgastro/article/view/5322engHellenic Society of GastroenterologyCopyright (c) 2020 Annals of Gastroenterology1792-74631108-7471Annals of Gastroenterology; Volume 33, No 6 (2020); 615Gastrointestinal predictors of severe COVID-19: systematic review and meta-analysisinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion2020-11-28Δημοσίευση σε περιοδικόPublication in journalΓαστροεντερολογίαGastroenterologyisi -Gastroenterology & Hepatology covers resources on the anatomy, physiology, biochemistry, and pathology of the digestive system. This category includes specific resources on the prognosis and treatment of digestive diseases; stomach ulcers; metabolic, genetic, infectious and chemically induced diseases of the liver; colitis; diseases of the pancreas and diseases of the rectum.Επιστημονικό άρθροScientific articleΕλληνική Γαστροεντερολογική ΕταιρίαGreek Aggregator OpenArchives.gr | National Documentation Centre (EKT)other