The individual studies in our analysis were at high risk of bias. The majority of studies reported on cohorts of patients based on inclusion dates and did not specify whether these were consecutive patients. There was an inconsistent assessment of symptoms and/or laboratory tests with missing data, and none of the studies reported whether patients were systematically evaluated for GI symptoms on admission. Most studies did not report on the duration of the GI symptoms preceding the presentation. When GI symptoms were reported, it was difficult to discern whether these were isolated symptoms or whether patients also had concurrent typical COVID-19 symptoms (eg, fever cough or shortness of breath). LFTs were mostly reported as the mean/median value of the entire cohort and without cutoff values for the institution. Many of the studies did not report on underlying chronic GI or liver diseases. There was a lot of heterogeneity in our pooled estimates that could not be explained by our subgroup analysis based on geographic location. Lastly, the data on prognosis were especially difficult to analyze due to insufficient follow-up of the patients (the majority of the patients were still hospitalized at the time of publication). Finally, there was no stratification of GI-related symptoms and severity of COVID-19 or patient important outcomes, such as need for intensive care unit or survival.