Gastroenterological symptoms in COVID-19 patients with mild severity of the disease: opportunities to optimize antidiarrheal therapy

Abstract

Background. The novel coronavirus infection COVID-19 can be manifested by damage to the organs of the gastrointestinal tract (GIT). Damage to the gastrointestinal tract by the SARS-CoV-2 virus leads to a violation of the microbial-tissue complex of the mucous membrane of the digestive tract. A common gastroenterological manifestation of COVID-19 is diarrhea.
 Aim. Study of the clinical features of gastroenterological disorders and the possibility of optimizing the treatment of diarrheal syndrome in patients with COVID-19 with a mild form of viral infection.
 Materials and methods. The observation group consisted of 230 patients with mild COVID-19: K-group (n=115) with respiratory symptoms, I group (n=115) with gastrointestinal manifestations in combination and without signs of respiratory damage. In order to compare the effectiveness of treatment of diarrheal syndrome, patients of group I are randomized into 2 subgroups: Ia (n=58) prebiotic treatment (Zacofalk) and Ib (n=57) enterosorbents.
 Results. The development of gastrointestinal symptoms with SARS-CoV-2 infection is significantly more often noted in comorbid patients (67%). Gastrointestinal symptoms were dominated by diarrhea (93.9%) and flatulence (76.5%), in 1/3 of patients they were the first manifestos of infection. It was established that in 98.4% of patients of group I (against 42.6% of the K-group) signs of infectious intoxication were detected. In patients with gastrointestinal lesions, an elongation of the febrile period by 91.5 days was noted, a later (6 days) verification of the viral etiology of the disease. It was found that in patients of group I, the regression of clinical symptoms, the duration of viral disease, the dynamics of antibody formation, the prognosis for the development of IBS-like disorders in the post-infectious period depended on the treatment. In patients taking (Zacofalk), these indicators were significantly better.
 Conclusion. In mild cases, to reduce the severity of viral intestinal damage, for effective relief of intestinal symptoms, to reduce the risk of IBS-like symptoms, it is advisable to prescribe (Zacofalk) in an initial dose of 3 tablets per day.

Gastrointestinal disorders in post-COVID syndrome. Clinical guidelines

“…Использование препаратов масляной кислоты в комплексной терапии у пациентов с диареей на фоне новой коронавирусной инфекцией способствовало более быстрой регрессии проявлений поражения ЖКТ [272]. [255].…”

“…Пищевые волокна способствуют увеличению частоты дефекации при запоре. Пшеничные отруби часто могут вызывать метеоризм, поэтому около 50% пациентов самостоятельно отменяют их [272].…”

Factors affecting the severity of COVID-19 and the development of complications

“…GI symptoms increase the risk of adverse and life-threatening complications of COVID-19. The most common GI manifestations of COVID-19 are anorexia, diarrhea, nausea, abdominal pain, and vomiting [54,55]. Erosions and ulcers of the gastrointestinal mucosa can also be observed [56].…”