This systematic review and meta-analysis showed patients with severe COVID-19 had higher rates of gastrointestinal symptoms and liver injury compared with those with non-severe disease. 

• 35 studies included in the meta-analysis
• The pooled prevalence of digestive symptoms was 15% (95%CI: 10–21)
• The pooled prevalence of liver injury was 19% (95%CI: 9–32). The pooled prevalence of increased ALT was 18% (95%CI: 13–25), increased AST was 21% (95%CI: 14–29), and increased total bilirubin was 6% (95%CI:3–13). The pooled prevalence of decreased albumin was 6% (95%CI:3–11)
• Patients with digestive involvement have a tendency to progress to severe or critical disease and a poor disease course
• Approximately 10% of patients with COVID-19 might present with gastrointestinal symptoms only, without respiratory symptoms
• Patients with digestive system involvement as initial symptoms have delayed diagnosis of COVID-19