Gastrointestinal symptoms in patients hospitalized with COVID-19: Prevalence and outcomes
Jun Song1, Jay Patel1, Rishabh Khatri1
1Temple University Hospital, Department of Medicine, Temple University School of Medicine, 3401 North Broad Street, Philadelphia, PA.
Insights
Patients hospitalized with coronavirus disease 2019 (COVID-19) who experience gastrointestinal (GI) symptoms generally have better outcomes. However, isolated GI symptoms without other signs indicate worse clinical outcomes and warrant COVID-19 consideration.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Critical Care Medicine
Background:
- Clinical outcomes for patients with coronavirus disease 2019 (COVID-19) and gastrointestinal (GI) symptoms are inconsistently reported.
- Understanding the impact of GI symptoms on COVID-19 patient outcomes is crucial for effective management.
Purpose of the Study:
- To characterize clinical outcomes in hospitalized patients with COVID-19 who present with GI symptoms.
- To compare outcomes between patients with and without GI symptoms, and between isolated GI symptoms versus mixed symptoms.
Main Methods:
- Retrospective analysis of 750 adult patients hospitalized with COVID-19.
- Categorization of patients based on the presence of GI symptoms (any GI vs. non-GI only).
- Comparison of clinical outcomes including ICU admission, discharge disposition, and mortality.
Main Results:
- Patients with any GI symptoms (49.7%) showed better outcomes than those with non-GI symptoms (50.3%), including lower ICU rates (17.4% vs. 20.2%) and mortality (6.4% vs. 9.8%).
- Patients with isolated GI symptoms experienced worse outcomes, with higher ICU requirements (23.8% vs. 17.0%) and mortality (19.0% vs. 5.7%) compared to those with mixed GI and non-GI symptoms.
- Patients with any GI symptoms had higher discharge-to-home rates (77.2% vs. 67.4%).
Conclusions:
- Hospitalized COVID-19 patients with GI symptoms generally fare better than those without.
- Isolated GI symptoms in COVID-19 patients are associated with significantly worse clinical outcomes.
- New-onset GI symptoms like diarrhea, nausea, vomiting, or abdominal pain should prompt consideration of COVID-19, even without pulmonary symptoms.
Abstract:
To characterize outcomes in patients hospitalized with coronavirus disease 2019 (COVID-19) who present with gastrointestinal (GI) symptoms.Clinical outcomes in patients with COVID-19 associated with GI symptoms have been inconsistent in the literature.The study design is a retrospective analysis of patients, age 18 years or older, admitted to the hospital after testing positive for COVID-19. Clinical outcomes included intensive care unit requirements, rates of discharges to home, rates of discharges to outside facilities, and mortality.Seven hundred fifty patients met the inclusion criteria. Three hundred seventy three (49.7%) patients presented with at least one GI symptom and 377 (50.3%) patients presented with solely non-GI symptoms. Patients who presented with at least one GI symptom had significantly lower ICU requirements (17.4% vs 20.2%), higher rates of discharges home (77.2% vs 67.4%), lower rates of discharges to other facilities (16.4% vs 22.8%), and decreased mortality (6.4% vs 9.8%) compared with patients with non-GI symptoms. However, patients who presented with solely GI symptoms had significantly higher ICU requirements (23.8% vs 17.0%), lower rates of discharges home (52.4% vs 78.7%), higher rates of discharges to facilities (28.6% vs 15.6%), and higher mortality (19.0% vs 5.7%) compared with those with mixed GI and non-GI symptoms.Although patients with COVID-19 requiring hospitalization with GI symptoms did better than those without GI symptoms, those with isolated GI symptoms without extra-GI symptoms had worse clinical outcomes. COVID-19 should be considered in patients who present with new onset or worsening diarrhea, nausea, vomiting, and abdominal pain even without pulmonary symptoms.
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