Gastrointestinal symptoms in patients hospitalized with COVID-19

Abstract

To characterize outcomes in patients hospitalized with coronavirus disease 2019 (COVID-19) who present with gastrointestinal (GI) symptoms.Clinical outcomes in patients with COVID-19 associated with GI symptoms have been inconsistent in the literature.The study design is a retrospective analysis of patients, age 18 years or older, admitted to the hospital after testing positive for COVID-19. Clinical outcomes included intensive care unit requirements, rates of discharges to home, rates of discharges to outside facilities, and mortality.Seven hundred fifty patients met the inclusion criteria. Three hundred seventy three (49.7%) patients presented with at least one GI symptom and 377 (50.3%) patients presented with solely non-GI symptoms. Patients who presented with at least one GI symptom had significantly lower ICU requirements (17.4% vs 20.2%), higher rates of discharges home (77.2% vs 67.4%), lower rates of discharges to other facilities (16.4% vs 22.8%), and decreased mortality (6.4% vs 9.8%) compared with patients with non-GI symptoms. However, patients who presented with solely GI symptoms had significantly higher ICU requirements (23.8% vs 17.0%), lower rates of discharges home (52.4% vs 78.7%), higher rates of discharges to facilities (28.6% vs 15.6%), and higher mortality (19.0% vs 5.7%) compared with those with mixed GI and non-GI symptoms.Although patients with COVID-19 requiring hospitalization with GI symptoms did better than those without GI symptoms, those with isolated GI symptoms without extra-GI symptoms had worse clinical outcomes. COVID-19 should be considered in patients who present with new onset or worsening diarrhea, nausea, vomiting, and abdominal pain even without pulmonary symptoms.

Gastrointestinal symptoms among COVID‐19 patients presenting to a primary health care center of Nepal: A cross‐sectional study

“… 12 A study in the United States by Song et al suggested that patients with isolated GI symptoms without extra GI symptoms had significantly higher mortality rates and higher intensive care unit requirements. 39 ARDS, shock, and arrhythmia were the common causes of mortality in our study.…”

“…Schettino et al 17 and Livanos et al 13 found a lower mortality rate in COVID‐19 patients with GI symptoms, which is quite controversial as another study conducted in Wuhan reported more mortality in patients with GI symptoms along with respiratory symptoms 12 . A study in the United States by Song et al suggested that patients with isolated GI symptoms without extra GI symptoms had significantly higher mortality rates and higher intensive care unit requirements 39 . ARDS, shock, and arrhythmia were the common causes of mortality in our study.…”