Table 2.
Characteristics of the Studies Included for Meta-analysis:
| Study | Study date | Study location | No. | Age, y (unless otherwise noted) | Male, n/total (%) or n (%) | Severe disease,a n (%) |
Fever, n/total (%) or n (%) | Respiratory symptoms, n/total (%) or n (%) | All GI symptoms,b n (%) | Anorexia, n/total (%) or n (%) | Nausea/vomiting, n/total (%) or n (%) | Diarrhea, n/total (%) or n (%) | Abdominal pain/discomfort, n/total (%) or n (%) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| China | |||||||||||||
| Guan et al18 | December 11, 2019–29 January 2020 | 552 hospitals in China | 1099 | Median: 47 IQR 35–58 | 637/1096 (58.1) | 173 (15.7) | 975/1099 (88.7) | C: 745 (67.8) E: 370 (33.7) D: 205 (18.7) |
≥55 (5.0) | NA | 55 (5.0) | 42 (3.8) | NA |
| Cheng et al19 | Up to February 19 | Henan | 1079 | Mean: 46 Range: 3 mo–94 y |
573 (53.2) | 72 (5.7) | 553/605 (91.4) | C: 110/605 (18.2) E: 19/605 (3.1) |
21/605 (3.5) | NA | NA | NA | NA |
| Fang et al20 | January 27–February 14, 2020 | Hubei | 305 | Median: 57 | 146 (47.9) | 46 (15.1) | 163/201 (81.1) | C: 79/201 (39.3) | 159/201 (79.1) | 101/201 (50.2) | N: 59/201(29.4) V: 32/201(15.9) |
66/295 (22.4) | 12/201 (6.0) |
| Zhou et al5 | December 29, 2020–January 31, 2020 | Hubei | 191 | Median: 56 IQR: 46–67 |
119 (62.3) | 119 (62.3) | 180 (94.2) | C: 151 (79.1) E: 44 (23.0) |
≥9 (4.7) | NA | 7 (3.7) | 9 (4.7) | NA |
| Yang et al21 | January 17–February 10, 2020 | Zhejiang | 149 | Mean ± SD: 45.1 ± 13.4 | 81 (54.4) | 2 (1.3) | 114 (76.5) | C: 87 (58.4) E: 48 (32.2) D: 2 (1.3) |
≥11 (7.4) | NA | 2 (1.3) | 11 (7.4) | NA |
| Zhang et al22 | January 16–February 3, 2020 | Hubei | 140 | Median: 57 IQR: 25–87 | 71 (50.7) | 58 (41.4) | 110/120 (91.7) | C: 90/120 (75.0) D: 44/120 (36.7) |
55/139 (39.6) | 17/139 (12.2) | N: 24/139 (17.3) V: 7/139 (5.0) |
18/139 (12.9) | 8/139 (12.9) |
| Wang et al23 | January 1–28, 2020 | Hubei | 138 | Median: 56 IQR: 42–68 |
75 (54.3) | ICU: 36 (26.1) | 136 (98.6) | C: 82 (59.4) E: 37 (26.8) D: 43 (31.2) |
≥14 (10.1) | 55 (9.9) | N: 14 (10.1) V: 5 (3.6) |
14 (10.1) | 3 (2.2) |
| Liu et al24 | December 30, 2019–January 24, 2020 | Hubei | 137 | Median: 57 Range: 20–83 | 61 (44.5) | 34 (24.8) | 112 (81.8) | C: 66 (48.2) E:6 (4.4) D: 26 (19.0) |
11 (8.0) | NA | NA | 11 (8.0) | NA |
| Peng et al25 | January 20, 2020–February 15, 2020 | Hubei | 112 | Median: 67 IQR: 55–67 |
53 (47.3) | ICU: 16 (14.3) | 101 (90.2) | C: 76 (67.9) D: 13 (11.6) |
15 (13.4) | NA | NA | 15 (13.4) | NA |
| Zhao et al26 | NA | Hunan | 101 | Mean: 44.4 Range: 17–75 |
56 (55.4) | 14 (13.9) | 79 (78.2) | C: 63 (62.4) D: 1(1.0) |
≥3 (3.0) | NA | 2 (2.0) | 3 (3.0) | NA |
| Chen et al27 | January 1–20, 2020 | Hubei | 99 | Mean ± SD: 55.5 ± 13.1 Range: 21–82 |
67 (67.7) | 17 (17.2) | 82 (82.8) | C: 81 (81.8) D: 31 (31.3) |
≥2 (2.0) | 1 (1.0) | 2 (2.0) | NA | NA |
| Xu et al28 | January 23–February 4, 2020 | Guangdong | 90 | Median: 50 Range: 18–86 | 39 (43.3) | NA | 70 (77.8) | C: 57 (63.3) E: 11 (12.2) |
≥5 (5.6) | NA | N: 5 (5.6) V: 2 (2.2) |
5 (5.6) | NA |
| Li et al29 | January–February 2020 | Chongqing | 83 | Mean ± SD: 45 ± 12.3 | 44 (53.0) | 25 (30.1) | 7 2 (86.7) | C: 65 (78.3) E: 15 (18.1) D: 9 (10.8) |
7 (8.4) | NA | NA | 7 (8.4) | |
| Shi et al30 | December 20, 2019–January 23, 2020 | Hubei | 81 | Mean ± SD: 49.5 ± 11.0 | 42 (51.9) | NA | 59 (72.8) | C: 48 (59.2) E: 15 (18.5) D: 34 (42.0) |
≥4 (4.9) | 1 (1.2) | V: 4 (4.9) | 3 (3.7) | NA |
| Wu et al31 | January 22–February 14, 2020 | Jiangsu | 80 | Mean ± SD: 46.1 ± 15.4 | 39 (48.8) | 3 (3.8) | 63 (78.8) | C: 51 (63.8) D: 30 (37.5) |
≥1 (1.3) | NA | 1 (1.3) | 1 (1.3) | NA |
| Wu et al32 | January–February 2020 | Chongqing | 80 | Mean ± SD: 44 ± 11 | 42 (52.5) | NA | 61 (76.3) | C: 58 (72.5) E: 11 (13.8) D: 7 (8.8) |
7 (8.8) | NA | NA | 7 (8.8) | |
| Fang et al33 | January 22–February 18, 2020 | Anhui | 79 | Mean ± SD: 45.1 ± 16.6 | 45 (60.0) | 24 (30.4) | 67 (84.8) | C: 45 (57.0) E: 10 (12.7) D: 9 (11.4) |
≥5 (6.3) | 5 (6.3) | NA | 4 (5.1) | NA |
| Xiao et al34 | February 1–14, 2020 | Guangdong | 73 | 43 Range: 10 mo–78 y |
41 (56.2) | ICU: 4 (5.5) | NA | 53 (72.6) | 26 (35.6) | NA | NA | 26 (35.6) | NA |
| Xu et al35 | January 10–26, 2020 | Zhejiang | 62 | Median: 41 IQR: 32–52 |
35 (56.5) | ICU: 1 (1.6) | 48 (77.4) | C: 50 (80.6) E: 35 (56.5) |
3 (4.8) | NA | NA | 3 (4.8) | NA |
| Zhou et al36 | January 16–30, 2020 | Hubei | 62 | Mean ± SD: 52.8 ± 12.2 Range: 30–70 |
39 (62.9) | NA | 54 | C: 28 D: 15 |
9 (14.) | NA | NA | 9 (14.) | |
| Yang et al37 | December 24, 2019–January 26, 2020 | Hubei | 52 | Mean ± SD: 59.7 ± 13.3 | 35 (67.3) | ICU: 52 (100) | 51 (98.1) | C: 40 (46.9) D: 33 (63.5) |
2 (3.8) | NA | 2 (3.8) | NA | NA |
| Xu et al38 | January–February 2020 | Beijing and Hebei | 50 | Mean ± SD: 43.9 ± 16.8 Range: 3–85 |
29 (58.0) | 13 (26) | 43 (86.0) | C:20 (40.0) E: 7 (14.0) D: 4 (8.0) |
1 (2.0) | NA | NA | NA | NA |
| Xiong et al39 | January 11–February 5, 2020 | Hubei | 42 | Mean ± SD: 49.5 ± 14.1 Range: 26–75 |
25 (59.5) | NA | 36 (85.7) | C: 27 (64.3) D: 8 (19.0) |
10 (23.8) | NA | NA | 10 (23.8) | NA |
| Huang et al40 | December 16, 2019–January 2, 2020 | Hubei | 41 | Median: 49 IQR: 41–58 |
30 (73.2) | ICU: 13 (31.7) | 40 (97.5) | C: 31 (75.6) E: 11/39 (28.2) D: 22/40 (55.0) |
1/38 (2.6) | NA | NA | 1/38 (2.6) | NA |
| Wu et al41 | January 19–25, 2020 | Tianjin | 40 | Mean: 45 Range: 10–76 |
13 (32.5) | 17 (42.5) | 38 (95.0) | C: 14 (35.0) E: 3 (7.5) D: 2 (5.0) |
≥6 (15.0) | NA | 3 (7.5) | 6 (15.0) | 3 (7.5) |
| Huang et al42 | December 21, 2019–January 8, 2020 | Hubei | 34 | Mean ± SD: 56.2 ± 17.1 Range: 26–88 |
14 (41.2) | 8 (23.5) | 32 (94.1) | C: 17 (50.0) E: 8 (23.5) D: 5 (14.7) |
5 (14.7) | NA | NA | 5 (14.7) | NA |
| Li et al43 | January–February 2020 | Hubei | 31 | Mean ± SD: 54 ± 13 | 18 (58.1) | 11 (35.5) | 25 (80.6%) | C: 25 (80.6) E: 16 (51.6) D: 10 (32.3) |
≥13 (41.9) | 13 (41.9) | 5 (16.1) | 3 (9.7) | NA |
| Liu et al44 | January 11–February 3, 2020 | Hubei | 30 | Mean ± SD: 35 ± 8 Range: 21–59 |
10 (33.3) | 4 (13.3) | 23 (76.7) | C: 25 (83.3) D: 14 (46.7) |
9 (30) | NA | N/V/D: 9 (30.0) | NA | |
| Pan et al45 | January 12–February 6, 2020 | Hubei | 21 | Mean ± SD: 40 ± 9 Range: 25–63 |
6 (28.6) | 0 | 18 (85.7) | C: 12 (57.1) E: 6 (28.6) |
9 (42.9) | 9 (42.9) | NA | NA | NA |
| Zou et al46 | January 7–26, 2020 | Guangdong | 18 | Median: 59 Range: 26–76 | 9 (50.0) | ICU: 3 (16.7) | 10 (55.6) | C: 10 (55.6) D: 3 (16.7) |
3 (16.7) | 1 (5.6) | N: 1 (5.6) | 1 (5.6) | 0 |
| Wang et al47 | January 21–February 5, 2020 | Henan | 18 | Median: 39 IQR: 29–55 |
10 (55.6) | ICU: 2 (11.1) | 17 (94.4) | C:10 (55.6) D: 4 (22.2) |
3 (16.7) | NA | 1 (5.6) | 3 (16.7) | NA |
| Zhang et al48 | January 27–February 10, 2020 | Zhejiang | 14 | Median: 41 IQR: 18–87 |
7 (50.0) | NA | 13 (92.9) | C: 10 (71.4) | NA | NA | 0 | 0 | NA |
| Chang et al49 | January 16–29, 2020 | Beijing | 13 | Median: 34 IQR: 34–78 |
10 (76.9) | 0 | 12 (92.3) | C: 6 (46.2) E: 2 (15.4) |
1 (7.7) | NA | NA | 1 (7.7.) | NA |
| Liu et al50 | Up to January 21, 2020 | Shenzen | 12 | Range: 10–72 | 8 (66.7) | 6 (50.0) | 10 (83.3) | C: 11 (91.7) | ≥3 (25.0) | NA | 2 (16.7) | 2 (16.7) | NA |
| Huang et al51 | January 21–February 1, 2020 | Jiangsu | 11 | NA | 4 (36.4) | NA | 9 (90.0) | C: 8 (80.0) | 1 (10.0) | NA | NA | 1 (10.0) | NA |
| Shen et al52 | February 2020 | Liaoning | 10 | Range: 33–85 | 6 (60) | 2 (20.0) | 9 (90) | C: 9 (90) | 4 (40.0) | NA | NA | 4 (40.0) | NA |
| Zhang et al53 | January 18–February 3, 2020 | Beijing | 9 | Median: 36 Range: 15–49 |
5 (55.6) | NA | 8 (88.9) | C: 5 (55.6) E: 1 (11.1) |
1 (11.1) | NA | NA | 1 (11.1) | NA |
| An et al54 | January 17–24, 2020 | Hubei | 9 | Median: 35.8 IQR: 28–45 | 4 (44.4) | 0 | After admission:5 (55.6) | After admission: 5 (55.6) |
9 (100) | 6 (66.7) | 1 (11.1) | 1 (11.1) | 0 |
| Qiu et al55 | February 3, 2020 | Henan | 8 | Range: 4–53 | 4 (50.0) | 0 | 5 (62.5) | C: 3 (37.5) | 1 (12.5) | NA | NA | 1 (12.5) | NA |
| Chan et al56 | January 10, 2020 | Shenzhen | 6 | Range: 36–66y | 3 (50) | 0 | 5 (83.3) | C: 4 (66.7) E: 1 (16.7) |
2 (33.3) | NA | NA | 2 (33.3) | NA |
| Ren et al57 | December 18–29, 2020 | Hubei | 5 | Range: 41–65 | 3 (60.0) | 4 (80.0) | 5 (100) | C: 5 (100) E: 1 (20.0) D: 4 (80.0) |
NA | NA | NA | 0 | NA |
| Wang et al58 | January 21–24, 2020 | Shanghai | 4 | Range: 19–63 | 3 (75.0) | 0 | 4 (100) | C: 3 (75.0) | NA | NA | NA | 0 | NA |
| Yu et al59 | January 20–23, 2020 | Shanghai | 4 | Range: 65–88 | 2 (50.0) | 1 (25.0) | 4 (100) | C: 1 (25.0) | 1 (25.0) | 1 (25.0) | NA | NA | NA |
| Yang et al60 | January 23–25, 2020 | Guandong | 3 | Range: 25–62 | 2 (66.7) | 0 | 2 (66.7) | C: 2 (66.7) E: 1 (33.3) |
2 (66.7) | 0 | 0 | 2 (66.7) | 0 |
| Huang et al61 | NA | Taiwan | 2 | Range: 73–74 | 0 | 0 | 2 (100) | C: 1 (50.0) | 2 (100) | 2 (100) | NA | 0 | 0 |
| Cheng et al62 | January 20, 2020 | Taiwan | 1 | 55 | 0 | 0 | 1 (100) | C: 1 (100) D: 1 (100) |
1 (100) | NA | NA | NA | 1 (100) |
| Li et al63 | January 24, 2020 | Sichuan | 1 | 33 | 1 (100) | 0 | 1 (100) | 0 | 1 (100) | 1 (100) | NA | NA | NA |
| Han et al64 | January 21, 2020 | Gansu | 1 | 47 | 1 (100) | 1 (100) | 1 (100) | C: 1 (100) | 1 (100) | NA | N: 1 (100) | NA | NA |
| Song et al65 | January 29, 2020 | Shandong | 1 | 22 | 1 (100) | 0 | 1 (100) | 0 | 1 (100) | NA | NA | 1 (100) | NA |
| Zhang et al66 | January 18, 2020 | Hubei | 1 | 57 | 1 (100) | 0 | 1 (100) | C: 1 (100) D: 1 (100) |
1 (100) | NA | NA | 1 (100) | NA |
| Wu et al67 | February 8, 2020 | Hubei | 1 | 48 | 1 (100) | 0 | 1 (100) | C: 1 (100) | NA | NA | 0 | NA | NA |
| Lin et al68 | January 25, 2020 | Gansu | 1 | 61 | 1 (100) | 0 | 0 | D: 1 (100) | NA | NA | NA | 0 | NA |
| Outside of China | |||||||||||||
| Kong et al69 | Up to February 14, 2020 | South Korea | 28 | Mean: 42.6 IQR: 20–73 |
15 (53.6) | NA | 9 (32.1) | Cough: 5 (17.9) | 2/18 (11.1) | NA | NA | 2/18 (11.1) (days 3 and 4) |
NA |
| Young et al70 | January 23– February 3, 2020 |
Singapore | 18 | Median: 41 Range: 31–73 | 9 (50.0) | 3 (16.7) | 13 (72.2) | C 15 (83.3) D: 2 (94.4) |
3 (16.7) | NA | NA | 3 (16.7) | NA |
| Kim et al71 | January 10–19, 2020 | South Korea | 2 | Range: 35–55 | 1 (50) | 1 (50.0) | 2 (100) | 2 (100) | 2 (50.0) | 0 | 0 | 2 (100) | 0 |
| Lillie et al72 | January 30–3,1 2020 | United Kingdom | 2 | Range: 23–50 | 1 (50.0) | 0 | 2 (100) | C: 2 (100) | 1 (50.0) | NA | NA | NA | NA |
| Phan et al73 | January 22, 2020 | Vietnam | 2 | Range: 27–65 | 2 (100) | 0 | 2 (100) | C: 1 (100) | 1 (50.0) | NA | 1 (50.0) | 1 (50.0) | NA |
| Yan et al74 | February 9–13 2020 | Singapore | 2 | Both 57 | 1 (50.0) | NA | 2 (100) | C: 2 (100) D: 1 (50.0) |
1 (50.0) | NA | NA | 1 (50.0) | NA |
| Holshue et al75 | January 20, 2020 | United States | 1 | 35 | 1 (100) | 1 (100) | 1 (100) | C: 1 (100) | 1 (100) | NA | 1 (100) | 1 (100) | 1 (100) |
| Pediatric patients | |||||||||||||
| Wang et al76 | January 25–February 21, 2020 | 6 provinces (northern China) | 31 | Median: 7.1 Range: 6 mo–17 y |
15 (48.4) | 0 | 20 (64.5) | C: 14 (45.2) E: 6 (19.4) |
5 (16.1) | NA | 2 (6.5) (1 as first presenting symptom) |
3 (9.7) (all as first presenting symptom) |
NA |
| Xia et al77 | January 23– February 8, 2020 | Hubei | 20 | Median: 2.1 Range: 1 d–14.6 y |
13 (65.0) | NA | 12 (60.0) | C: 13 (65.0) | ≥3 (15.0) | NA | 2 (10.0) | 3 (15.0) | NA |
| Cai et al78 | January 19, 2020– February 3, 2020 | Shanghai, Hainan, Anhui, and Shandong | 10 | Mean: 74 mo Range: 3–131 mo |
4 (40.0) | 0 | 8 (80.0) | C: 6 (60.0) | NA | NA | NA | 0 | NA |
| Chen et al79 | January 27, 2020 | Hubei | 1 | 13 mo | 1 (100) | 1 (100) | 1 (100) | 0 | 1 (100) | 1 (100) | 1 (100) | 1 (100) | NA |
| Zeng et al80 | February 5, 2020 | Hubei | 1 | 17 d | 1 (100) | 0 | 0 | 0 | 1 (100) | 1 (100) | 1 (100) | 1 (100) | NA |
| Zhang et al81 | January 26, 2020 | Hainan | 1 | 3 mo | 0 | 0 | 1 (100) | 0 | NA | 0 | 0 | 0 | NA |
| Pregnant women | |||||||||||||
| Chen et al82 | January 20–31, 2020 | Hubei | 9 | Range: 26–40 | 0 | NA | 7 (77.8) | C: 4 (44.4) D: 1 (11.1) |
1 (11.1) | NA | NA | 1 (11.1) | NA |
| Zhu et al83 | January 20–February 5, 2020 | Hubei | 9 | Range: 25–35 | 0 | NA | 8 (88.9) | C: 4 (44.4) | 1 (11.1) | NA | NA | 1 (11.1) | NA |
| Chen et al84 | January 21–February 4, 2020 | Hubei | 3 | Range: 23–34 | 0 | 0 | 1 (33.3) | D: 1 (33.3) | NA | NA | NA | 0 | NA |
| Liu et al85 | February 5, 2020 | Shandong | 1 | 38 | 0 | 0 | 0 | 0 | 1 (100) | 1 (100) | N: 1 (100) | 1 (100) | 0 |
C, cough; D, dyspnea; E, expectoration; GI, gastrointestinal; ICU, intensive care unit; N, nausea; NA, not available; SD, standard deviation; V, vomiting.
a
Severe disease was defined based on the American Thoracic Society and Infectious Disease Society of America guidelines for community-acquired pneumonia, need of ICU admission, and death.
b
If all gastrointestinal symptoms were not reported and the number of events of any individual gastrointestinal symptom was less than 1, it was regarded as not available and was excluded from the meta-analysis of all gastrointestinal symptoms. However, this study was still included in the meta-analysis of individual gastrointestinal symptoms if the proportion of patients with that symptom was reported.