Gastrointestinal implications in COVID-19

Area of Science:

• Infectious Diseases
• Gastroenterology
• Internal Medicine

Background:

• Coronavirus disease 2019 (COVID-19) primarily manifests with respiratory symptoms.
• Gastrointestinal (GI) symptoms can occur in COVID-19 patients, either independently or alongside respiratory issues.
• Understanding the spectrum of COVID-19 symptoms is vital for comprehensive patient care.

Purpose of the Study:

• To investigate the prevalence and characteristics of GI symptoms in COVID-19 patients.
• To identify potential differences between COVID-19 patients with and without GI manifestations.
• To highlight the importance of recognizing GI symptoms in the context of COVID-19.

Main Methods:

• A retrospective cross-sectional study involving 507 patients with confirmed or highly probable COVID-19.
• Patients were classified into four groups based on symptom presentation: GI symptoms alone (GIA), respiratory symptoms alone (RA), both GI and respiratory symptoms (GIR), and without GI or respiratory symptoms (WGIR).
• Medical records were analyzed to evaluate symptom patterns, demographics, laboratory findings, and outcomes.

Main Results:

• Nearly half (47.9%) of COVID-19 patients experienced at least one GI symptom, with nausea and/or vomiting being the most frequent (31.6%).
• Patients presenting solely with GI symptoms (GIA) were significantly older than those in the RA and GIR groups.
• Leukopenia and lymphopenia were less common in patients with GI symptoms. Positive RT-PCR tests were significantly less frequent in patients with GI symptoms (44% vs. 100%).

Conclusions:

• GI symptoms, particularly nausea and/or vomiting, frequently accompany typical respiratory symptoms in COVID-19.
• A distinct subset of COVID-19 patients may present exclusively with GI symptoms.
• Increased clinical awareness and prompt evaluation of GI symptoms in COVID-19 patients are essential to prevent misdiagnosis and treatment delays.