COVID-19 in Latin America: Symptoms, Morbidities, and Gastrointestinal Manifestations

Ashktorab, Hassan; Pizuorno, Antonio; Oskroch, Gholamreza; Fierro, Nora A.; Sherif, Zaki A.; Brim, Hassan

doi:10.1053/j.gastro.2020.10.033

Cited by 18 publications

(15 citation statements)

References 5 publications

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“…Obesity has been described as a negative marker in COVID-19 patients’ outcomes, primarily because of obesity-associated pro-inflammation, excessive oxidative stress, impaired immunity, and a creator/trigger of metabolic syndrome[ 17 , 18 ]. Our findings showed that 20.2% were obese, 18.6% overweight and 14.8% regular BMI patients died.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 among African Americans and Hispanics: Does gastrointestinal symptoms impact the outcome?

Ashktorab

Adeleye

Pizuorno

et al. 2021

WJCC

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BACKGROUND The coronavirus disease 2019 (COVID-19) disproportionately affected African Americans (AA) and Hispanics (HSP). AIM To analyze the significant effectors of outcome in African American patient population and make special emphasis on gastrointestinal (GI) symptoms, laboratory values and comorbidities METHODS We retrospectively evaluated the medical records of 386 COVID-19 positive patients admitted at Howard University Hospital between March and May 2020. We assessed the symptoms, including the GI manifestations, comorbidities, and mortality, using logistic regression analysis. RESULTS Of these 386 COVID-19 positive patients, 257 (63.7%) were AAs, 102 (25.3%) HSP, and 26 (6.45%) Whites. There were 257 (63.7%) AA, 102 (25.3%) HSP, 26 (6.45%) Whites. The mean age was 55.6 years (SD = 18.5). However, the mean age of HSP was the lowest (43.7 years vs 61.2 for Whites vs 60 for AAs). The mortality rate was highest among the AAs (20.6%) and lowest among HSP (6.9%). Patients with shortness of breath (SOB) (OR2 = 3.64, CI = 1.73-7.65) and elevated AST (OR2 = 8.01, CI = 3.79-16.9) elevated Procalcitonin (OR2 = 8.27, CI = 3.95-17.3), AST (OR2 = 8.01, CI = 3.79-16.9), ferritin (OR2 = 2.69, CI = 1.24-5.82), and Lymphopenia (OR2 = 2.77, CI = 1.41-5.45) had a high mortality rate. Cough and fever were common but unrelated to the outcome. Hypertension and diabetes mellitus were the most common comorbidities. Glucocorticoid treatment was associated with higher mortality (OR2 = 5.40, CI = 2.72-10.7). Diarrhea was prevalent (18.8%), and GI symptoms did not affect the outcome. CONCLUSION African Americans in our study had the highest mortality as they consisted of an older population and comorbidities. Age is the most important factor along with SOB in determining the mortality rate. Overall, elevated liver enzymes, ferritin, procalcitonin and C-reactive protein were associated with poor prognosis. GI symptoms did not affect the outcome. Glucocorticoids should be used judiciously, considering the poor outcomes associated with it. Attention should also be paid to monitor liver function during COVID-19, especially in AA and HSP patients with higher disease severity

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Section: Discussionmentioning

confidence: 99%

COVID-19 among African Americans and Hispanics: Does gastrointestinal symptoms impact the outcome?

Ashktorab

Adeleye

Pizuorno

et al. 2021

WJCC

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“…Several studies and metaanalyses have pointed out the gastrointestinal involvement in the SARS-CoV-2 infection [3], [4], [6], [8], [25]- [27]. The data from the pooled prevalence of gastrointestinal symptoms are varying significantly from 10.5% to 53% between studies [3], [4], [25], [28].…”

Section: Discussionmentioning

confidence: 99%

A machine learning approach for identification of gastrointestinal predictors for the risk of COVID-19 related hospitalization

Liptak

Bánovčin

Rosolanka

et al. 2021

Preprint

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Background and aim: COVID-19 can be presented with various gastrointestinal symptoms. Shortly after the pandemic outbreak several machine learning algorithms have been implemented to assess new diagnostic and therapeutic methods for this disease. Aim of this study is to assess gas-trointestinal and liver related predictive factors for SARS-CoV-2 associated risk of hospitalization. Methods: Data collection was based on questionnaire from the COVID-19 outpatient test center and from the emergency department at the University hospital in combination with data from inter-nal hospital information system and from the mobile application used for telemedicine follow-up of patients. For statistical analysis SARS-CoV-2 negative patients were considered as controls to three different SARS-CoV-2 positive patient groups (divided based on severity of the disease). Results: Total of 710 patients were enrolled in the study. Presence of diarrhea and nausea was significantly higher in emergency department group than in the COVID-19 outpatient test center. Among liver enzymes only aspartate transaminase (AST) has been significantly elevated in the hospitalized group compared to patients discharged home. Based on random forest algorithm, AST has been identified as the most important predictor followed by age or diabetes mellitus. Diarrhea and bloating have also predictive importance although much lower than AST. Conclusion: SARS-CoV-2 positivity is connected with isolated AST elevation and the level is linked with the severity of the disease. Furthermore, using machine learning random forest algo-rithm, we have identified elevated AST as the most important predictor for COVID-19 related hos-pitalizations.

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“…As for Latin America, currently the epicenter of the pandemic, Ashktorab et. al [ 22 ] reported that diarrhea, nausea, vomiting and abdominal pain, were highly prevalent, but not associated with higher mortality. In another study on an Iranian cohort, Mokarram et.…”

Section: Gi Symptoms and Comorbidities In Covid-19 Outcomementioning

confidence: 99%

Gastrointestinal manifestations and SARS-CoV-2 infection

Pizuorno

Brim

Ashktorab

2021

Current Opinion in Pharmacology

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Since COVID-19 occurrence in late 2019, intense research efforts on an unprecedented scale have focused on the study of SARS CoV-2 entry mechanisms and clinical presentations. As for other coronaviruses, SARS-CoV-2 presents with extra-respiratory clinical manifestations like diarrhea, nausea, vomiting and abdominal pain which highlight that the gastrointestinal (GI) system as another viral target along with the typical presentations of COVID-19 which is characterized primarily by respiratory symptoms. The digestive system is involved in many systemic functions through the gut-brain-axis and systemic immunity modulation. Therefore, the GI system plays an important role in the presentation of the disease, pathogenesis, and possibly treatment outcome. This mini-review summarizes recent work to study SARS-CoV-2 infection as it relates to comorbidities, GI symptoms. This will help to strategize the priorities in understanding the impact of the virus on outcome in various aspects.

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COVID-19 in Latin America: Symptoms, Morbidities, and Gastrointestinal Manifestations

Cited by 18 publications

References 5 publications

COVID-19 among African Americans and Hispanics: Does gastrointestinal symptoms impact the outcome?

COVID-19 among African Americans and Hispanics: Does gastrointestinal symptoms impact the outcome?

A machine learning approach for identification of gastrointestinal predictors for the risk of COVID-19 related hospitalization

Gastrointestinal manifestations and SARS-CoV-2 infection

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