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Gastrointestinal symptoms in COVID-19 and disease severity: a Japanese registry-based retrospective cohort study

Yuta Matsubara1, Hiroki Kiyohara2, Yohei Mikami1

  • 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, Japan.

Journal of Gastroenterology
|January 25, 2024
PubMed

Insights

Diarrhea in COVID-19 patients was linked to a lower chance of needing intensive care or mechanical ventilation. This suggests diarrhea may indicate a milder form of Coronavirus Disease 2019 (COVID-19).

Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Clinical Medicine

Background:

  • Previous research on gastrointestinal (GI) symptoms and Coronavirus Disease 2019 (COVID-19) severity yielded inconclusive results.
  • Understanding the correlation between GI symptoms and COVID-19 prognosis is crucial for patient management.

Purpose of the Study:

  • To investigate the association between the presence of gastrointestinal symptoms and the clinical outcomes of COVID-19 patients.
  • To clarify the prognostic significance of GI symptoms in the context of COVID-19 severity.

Main Methods:

  • A retrospective cohort study was conducted using data from the Japanese nationwide registry for COVID-19.
  • Data from 3498 hospitalized and outpatient COVID-19 patients diagnosed between February 2020 and August 2022 were analyzed.
  • Multivariable-adjusted logistic regression models were employed to assess associations between GI symptoms and clinical outcomes.

Main Results:

  • The prevalence of diarrhea, nausea/vomiting, abdominal pain, and melena was 16.6%, 8.9%, 3.5%, and 0.7%, respectively.
  • Diarrhea was associated with a significantly lower likelihood of intensive care unit (ICU) admission (aOR, 0.70; 95% CI, 0.53-0.92) and mechanical ventilation (aOR, 0.61; 95% CI, 0.42-0.89).
  • Sensitivity analyses confirmed these findings, indicating a protective association of diarrhea with severe COVID-19 outcomes.

Conclusions:

  • Diarrhea in COVID-19 patients is associated with better clinical outcomes.
  • The presence of diarrhea may serve as an indicator of a less severe disease course in Coronavirus Disease 2019.
Abstract

Keywords:
COVID-19DiarrheaGastrointestinal symptomJapaneseSeverity

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