Abdominal pain patterns during COVID-19: an observational study

Area of Science:

• Gastroenterology
• Infectious Diseases
• Hepatology

Background:

• Abdominal pain and liver injury are frequently observed in patients with coronavirus disease-2019 (COVID-19).
• Understanding the characteristics of abdominal pain in COVID-19 is crucial for assessing disease severity and potential liver involvement.

Purpose of the Study:

• To investigate the characteristics of abdominal pain in hospitalized COVID-19 patients.
• To determine the association between abdominal pain patterns, COVID-19 severity, and liver injury.

Main Methods:

• Retrospective analysis of hospitalized COVID-19 patients during the first wave.
• Exclusion of patients with alternative diagnoses for abdominal pain, pregnant women, and those admitted for other conditions.
• Analysis of pain location, association with disease severity (mortality, ICU admission), dyspnea, and liver enzyme levels (transaminases, AST).

Main Results:

• 19.5% of COVID-19 patients reported spontaneous abdominal pain, often in the epigastric (42.7%) or right upper quadrant (25.5%).
• Right upper quadrant tenderness correlated with severe COVID-19 (OR 2.81).
• Elevated transaminases, particularly AST, were associated with upper abdominal pain and severe COVID-19 (OR 16.03).

Conclusions:

• Abdominal pain is a significant symptom in over one-fifth of COVID-19 hospitalizations.
• Upper abdominal pain in COVID-19 patients is linked to increased risk of dyspnea, altered liver enzymes, and adverse outcomes.
• Abdominal pain characteristics can serve as indicators for COVID-19 severity and hepatic complications.