Frequency and outcomes of gastrointestinal symptoms in patients with Corona Virus Disease-19
Hayley K Rogers1, WonSeok W Choi2, Niraj Gowda2
1Department of Internal Medicine, George Washington University, 2150 Pennsylvania Avenue, NW Suite 5-416, Washington, D.C., 20037, USA. hkrogers@gwu.edu.
Insights
Gastrointestinal symptoms, particularly diarrhea, were present in 25.9% of hospitalized COVID-19 patients. Diarrhea was associated with increased mortality, ICU admission, and need for intubation, highlighting its clinical significance.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Critical Care Medicine
Background:
- Gastrointestinal (GI) symptoms are increasingly recognized as potential indicators of disease severity in COVID-19.
- Understanding the frequency and impact of GI symptoms in hospitalized patients is crucial for risk stratification and management.
Purpose of the Study:
- To determine the prevalence of GI symptoms in hospitalized COVID-19 patients.
- To investigate the association between specific GI symptoms and clinical outcomes, including mortality, ICU admission, and need for mechanical ventilation.
Main Methods:
- Retrospective collection of data from hospitalized COVID-19 patients at a tertiary care center.
- Multivariate logistic regression analysis adjusted for clinical demographics and comorbidities.
Main Results:
- GI symptoms were present in 25.9% of patients, with diarrhea being the most common (12.8%).
- Patients with diarrhea had significantly higher odds of mortality (OR 2.75), ICU admission (OR 2.24), and intubation (OR 3.16).
- Diarrhea was also associated with increased likelihood of requiring vasopressors, shock, and acute kidney injury.
Conclusions:
- Gastrointestinal symptoms, especially diarrhea, should be routinely screened for in COVID-19 patients.
- The presence of diarrhea in COVID-19 patients may indicate a more severe disease course and poorer outcomes.
- Healthcare providers should consider GI symptoms, particularly diarrhea, when assessing disease severity and prognosis in COVID-19 patients.
Objectives:
To characterize the frequency and association of gastrointestinal (GI) symptoms with outcomes in patients with corona virus disease 2019 (COVID-19) admitted to the hospital.
Methods:
Records were retrospectively collected from patients admitted to a tertiary care center in Washington, D.C., with confirmed COVID-19 from March 15, 2020 to July 15, 2020. After adjusting for clinical demographics and comorbidities, multivariate logistic regression analysis was performed.
Results:
The most common presenting symptoms of COVID-19 in patients that were admitted to the hospital were cough (38.4%), shortness of breath (37.5%), and fever (34.3%), followed by GI symptoms in 25.9% of patients. The most common GI symptom was diarrhea (12.8%) followed by nausea or vomiting (10.5%), decreased appetite (9.3%), and abdominal pain (3.8%). Patients with diarrhea were more likely to die (odds ratio [OR] 2.750; p = 0.006; confidence interval [CI] 1.329-5.688), be admitted to the intensive care unit (ICU) (OR 2.242; p = 0.019; CI 1.139-4.413), and be intubated (OR 3.155; p = 0.002; CI 1.535-6.487). Additional outcomes analyzed were need for vasopressors, presence of shock, and acute kidney injury. Patients with diarrhea were 2.738 (p = 0.007; CI 1.325-5.658), 2.467 (p = 0.013; CI 1.209-5.035), and 2.694 (p = 0.007; CI 1.305-5.561) times more likely to experience these outcomes, respectively.
Conclusions:
Screening questions should be expanded to include common GI symptoms in patients with COVID-19. Health care providers should note whether their patient is presenting with diarrhea due to the potential implications on disease severity and outcomes.
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