GI symptoms as early signs of COVID-19 in hospitalised Italian patients

Buscarini, Elisabetta; Manfredi, Guido; Brambilla, Gianfranco; Menozzi, Fernanda; Londoni, C.; Alicante, Saverio; Iiritano, E.; Romeo, S.; Pedaci, Marianna; Benelli, Giampaolo; Canetta, Ciro; Piana, Giuseppe La; Merli, Guido; Scartabellati, Alessandro; Viganò, Giovanni; Sfogliarini, Roberto; Melilli, G. A.; Assandri, Roberto; Cazzato, Daniele; Rossi, Davide Sebastiano; Usai, Susanna; Tramacere, Irene; Pellegata, Germano; Lauria, Giuseppe

doi:10.1136/gutjnl-2020-321434

Cited by 55 publications

(39 citation statements)

References 10 publications

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“…Surprisingly, intestinal disorders appeared to be correlated with a favorable evolution. This was already suggested in Buscarini's study [20], even though found not significant. Among hematological parameters, low lymphocytes count and high NLR ratio at admission were correlated with a UFE.…”

Section: Discussionmentioning

confidence: 46%

Covid-19: contribution of clinical characteristics and laboratory features for early detection of patients with high risk of severe evolution

Sepulchre

Pittie

Stojkovic

et al. 2020

Acta Clinica Belgica

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Background: The aim of this study was to identify early clinical and laboratory predictive factors of a severe coronavirus disease 2019 (COVID-19). Methods: A retrospective study was conducted on adult patients hospitalized for COVID-19 in our hospital. Diagnosis was based on a positive real-time reverse transcription-polymerase chain reaction (RT-PCR) on nasopharyngeal samples. The cohort was divided into two groups, i. e. a favorable evolution (FE) group and an unfavorable evolution (UFE) group, including intensive care unit (ICU) and deceased patients. Results: A total of 198 patients were enrolled in the study, with 138 FE (70%) and 60 UFE (30%). Older age, male gender, comorbidities and dyspnea at admission constituted significantly worse prognosis factors. Among laboratory features, lymphocyte and platelet counts as well as corrected glomerular filtration rate were significantly lower in UFE patients, while neutrophil to lymphocyte ratio, inflammation biomarkers, creatinine, aspartate aminotransferase, lactate dehydrogenase (LDH), glycemia and D-dimer were significantly higher. Procalcitonin and LDH appeared as the most accurate variables according to receiver operating characteristic curves. Conclusions: This Belgian study revealed clinical and laboratory features able to predict high risk of ICU requirement, or even death, at admission time. These results provide a potential tool for patient's triage in a context of pandemic.

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Section: Discussionmentioning

confidence: 46%

Covid-19: contribution of clinical characteristics and laboratory features for early detection of patients with high risk of severe evolution

Sepulchre

Pittie

Stojkovic

et al. 2020

Acta Clinica Belgica

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“… 12 Furthermore, it has been shown that gastrointestinal symptoms can sometimes precede respiratory involvement and be the first manifestation of the infection. 13 These data suggest the possible need to include SARS-CoV-2 infection among the differential diagnosis of acute diarrhea and/or vomiting, at least for the duration of this pandemic.…”

Section: Covid-19 and Gastrointestinal System: Clinical Aspectsmentioning

confidence: 94%

The Thrilling Journey of SARS-CoV-2 into the Intestine: From Pathogenesis to Future Clinical Implications

Scaldaferri

Ianiro

Privitera

et al. 2020

Inflammatory Bowel Diseases

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has a direct impact on the gastrointestinal system, as up to 50% of fecal samples from coronavirus disease 2019 (COVID-19) patients contain detectable viral RNA despite a negative rhino-pharyngeal swab. This finding, together with an intestinal expression of angiotensin conversion enzyme 2 protein, suggests a possible fecal-oral transmission for SARS-CoV-2. Furthermore, gastrointestinal (GI) symptoms are common in COVID-19 patients including watery diarrhea, vomiting—particularly in children—nausea, and abdominal pain. Pathogenesis of SARS-CoV-2 infection presents significant similarities to those of some immune-mediated diseases, such as inflammatory bowel diseases or rheumatoid arthritis, leading to the hypothesis that targeted therapies used for the treatment of immune-mediated disease could be effective to treat (and possibly prevent) the main complications of COVID-19. In this review, we synthesize the present and future impact of SARS-CoV-2 infection on the gastrointestinal system and on gastroenterology practice, hypothesizing a potential role of the “gut-lung axis” and perhaps of the gut and lung microbiota into the interindividual differential susceptibility to COVID-19 19 disease. Finally, we speculate on the reorganization of outpatient gastroenterology services, which need to consider, among other factors, the major psychological impact of strict lockdown measures on the whole population.

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“…In 2020, the sports world was halted by a global pandemic that resulted in a stoppage of most athletic competitions. The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) responsible for the respiratory condition known more commonly as COVID-19 can result in pneumonia-like symptoms and may elicit an inflammatory cascade impacting the bronchioles, alveoli, cardiovascular system, and myocardial tissue (Buscarini et al, 2020 ; Cipollaro et al, 2020 ; Ding et al, 2020 ; Lovato and De Filippis, 2020 ). In March of 2020, the World Health Organization (WHO) classified COVID-19 as a global pandemic (World Health Organization, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

The Impact of COVID-19-Related Shutdown Measures on the Training Habits and Perceptions of Athletes in the United States: A Brief Research Report

Jagim

Luedke

Fitzpatrick

et al. 2020

Front. Sports Act. Living

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The purpose of the current study was to examine the impact of COVID-19 government-enforced shutdown measures on the training habits and perceptions of athletes. A web-based electronic survey was developed and distributed online to athletes. The survey contained questions regarding currently available resources, changes in weekly training habits, and perceptions of training such as intensity, motivation, and enjoyment. A total of 105 (males: n = 31; females: n = 74) athletes completed the survey (mean ± SD age = 19.86 ± 2.13 years). Ninety-nine (94.3%) athletes continued to receive guidance from their primary sport coach or strength training staff. There was a significant (p < 0.001) decrease (mean ± SD) in self-reported participation time for strength training (−1.65 ± 4.32 h. week−1), endurance (−1.47 ± 3.93 h. week−1), and mobility (−1.09 ± 2.24 h. week−1), with the largest reduction coming from participation time in sport-specific activities (−6.44 ± 6.28 h. week−1) pre- to post-shutdown. When asked to rate their current state of emotional well-being using a visual analog scale of 0–100, with 100 being exceptional, the mean score was 51.6 ± 19.6 AU. Athletes experienced notable reductions in training frequency and time spent completing various training related activities. In the future, practitioners should have preparations in place in the event of another lockdown period or future pandemic to avoid or minimize significant disruptions in training. Special considerations may be needed when athletes are allowed to return to sport in the event of significant levels of detraining that may have occurred.

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GI symptoms as early signs of COVID-19 in hospitalised Italian patients

Abstract: Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

Cited by 55 publications

References 10 publications

Covid-19: contribution of clinical characteristics and laboratory features for early detection of patients with high risk of severe evolution

Covid-19: contribution of clinical characteristics and laboratory features for early detection of patients with high risk of severe evolution

The Thrilling Journey of SARS-CoV-2 into the Intestine: From Pathogenesis to Future Clinical Implications

The Impact of COVID-19-Related Shutdown Measures on the Training Habits and Perceptions of Athletes in the United States: A Brief Research Report

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