A cross-sectional study of gastrointestinal manifestations in COVID-19 Egyptian patients

Abstract

Background The latest novel corona virus disease (COVID-19) pandemic shows a significant health concern. We aimed to study the prevalence of gastrointestinal symptoms among COVID-19 Egyptian patients. Methods A cross-sectional study was carried out on 860 patients with COVID-19 infection classified according to Ministry of Health Program (MOHP) into three groups (280 patients with mild disease, 258 patients with moderate disease and 322 patients with severe disease). All patients were subjected to medical history, clinical examination, laboratory investigations, high-resolution computed tomography chest (HRCT chest) and other investigations when needed in some patients e.g., upper gastro-intestinal (GI) endoscopy, abdomino-pelvic ultrasound and ECHO. Results Gastro-intestinal symptoms were present in 27.2% of the studied patients. The most common reported GIT symptoms were vomiting, diarrhea, abdominal/gastric pain, followed by nausea.GIT symptoms presence was significantly higher in severe cases in comparison to mild or moderate cases. C-reactive protein (CRP), serum ferritin, Aspartate aminotransferase (AST), bilirubin and creatinine were significantly associated with the presence of GI symptoms. Conclusions GI symptoms are prevalent among COVID-19 patients, the most common which were vomiting and diarrhea and were associated with COVID-19 severity.

Prognostic Value of Transaminases and Bilirubin Levels at Admission to Hospital on Disease Progression and Mortality in Patients with COVID-19—An Observational Retrospective Study

“…Our data are in line with other similar studies in the literature [12][13][14][15][16][17][18][19][20][21][22]. Those studies, mainly performed in the USA, showed a significant association between the increase in liver function and disease progression or death in patients with COVID-19 [20][21][22].…”

“…In addition, the increase in bilirubin levels at time of hospital admission is significantly related to hospital mortality; however, also considering the minor association, further research is required to validate the data shown. Considering the need for tools and prognostic examinations that can help to predict the clinical progression of disease in COVID-19 patients, our study, with others recently published [8][9][10][11][12][13][14][15][16][17][18][19], could be a useful guide, using liver damage and liver function tests to highlight patients at risk of COVID-19 progression or to predict the severity of disease progression.…”

“…Liver damage is likely multifactorial: it may be due not only to direct viral damage, but also due to a systemic cytokine storm, pro-thrombotic state, drug use and abuse during COVID-19, and hypoxic injury [8]. Finally, several studies have investigated the role of liver enzymes on disease progression and mortality [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22], showing a relation between the elevation of liver enzymes, considered as a manifestation of liver damage, and the severity of COVID-19 disease. In addition, the impact that the SARS-CoV-2 pandemic has determined on patients with liver disease has been considerable for both outpatient and inpatient management [23][24][25].…”

Impact of COVID-19 on digestive system: prevalence, clinical characteristics, outcome, and relation to the severity of COVID-19

“…Within our cohort, 104 (34.7%) patients presented with GI symptoms which is lower than the results reported by other studies conducted in the USA and China which were in the range of 50.5-61.3% [10,12]. In contrast, this prevalence was higher than other studies conducted in China, Italy, and Egypt [7,22,24,25].…”

Evaluation of the Impact of Local Protocol of King Salman Specialized Hospital-KSA of Management of Renal Disease patients requiring Immunosuppressive Therapy Afflicted by Acute COVID 19 Infection – an Observational Study

“…On the contrary, Hegazy, and colleagues, 2021 conveyed that patients with mild symptoms who present with diarrhea and duration of symptoms longer than 12 days are expected to have a worse prognosis [23]. Moreover, Teimaa and his associates, 2022 found that the presence of associated gastrointestinal symptoms in COVID19 infection patients reflected the severity of the infection [24]. In summary, Sulaiman and his colleagues, 2020 reported that the presence of COVID19related gastrointestinal symptoms alone carried a better prognosis while their presence with respiratory symptoms was associated with higher morbidity and mortality [25].…”