Gastrointestinal manifestations in symptomatic Coronavirus disease - 19  patients and its relevance in predicting severity and outcome

Introduction Recent developments characterizing the pathophysiological basis of infection in the Coronavirus disease - 19 (COVID-19) have stirred great interest in studying this disease outside the purview of respiratory involvement and especially focusing on the gastrointestinal (GI) system. The pr...

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Published in:Indian journal of gastroenterology 2023-08, Vol.42 (4), p.485-495
Main Authors: Padmaprakash, K. V., Thareja, Sandeep, Raman, Nishant, Muthukrishnan, J., Miglani, Aman, Summi, Pankaj, Reddy, S. Naveen
Format: Article
Language:English
Subjects:
Anorexia - complications
COVID-19 - complications
COVID-19 - diagnosis
Gastroenterology
Gastrointestinal Diseases - diagnosis
Gastrointestinal Diseases - etiology
Hepatology
Humans
Medicine
Medicine & Public Health
Original Article
Retrospective Studies
SARS-CoV-2
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Summary:Introduction Recent developments characterizing the pathophysiological basis of infection in the Coronavirus disease - 19 (COVID-19) have stirred great interest in studying this disease outside the purview of respiratory involvement and especially focusing on the gastrointestinal (GI) system. The present study involving a large cohort of COVID-19-infected patients reports on the characteristics of GI manifestations in patients infected with COVID-19 as well as the predictive role in their association with disease severity and adverse outcomes. Methods A retrospective cohort study was carried out in a tertiary care hospital in northern India. Descriptive analysis of GI symptoms was carried out followed by predictive analysis assessing COVID-19 severity and with the primary endpoint of 28-day in-hospital all-cause mortality. Results Of 3842 hospitalized COVID-19 patients, 2113 (55%) were symptomatic. GI symptoms were present in 163 (7.1%) patients. Common GI symptoms were diarrhea 65 (3.1%), anorexia 61 (2.9%) and vomiting 37 (1.8%). Mild and moderate-to-severe disease was seen in 1725 (81.6%) and 388 (18.4%) patients, respectively. Logistic regression showed greater odds of moderate-to-severe disease in patients with any GI symptoms (odds ratio [OR] 1.849, 95% CI 1.289–2.651 [ p  = 0.001]) and anorexia in particular (OR 2.797, 95% CI 1.647–4.753 [ p  = 0.001]); however, on multivariable-analysis, this association lost its significance. A total of 172 patients succumbed to illness. In the Cox proportional hazards model for mortality, patients with any GI symptom (HR 2.184, 95 CI 1.439–3.317 [ p  
ISSN:0254-8860
0975-0711
DOI:10.1007/s12664-023-01370-8