Outcome of COVID-19 Patients Presented with Gastrointestinal and Hepatic Manifestations

Abstract

Background. COVID-19 is rapidly spreading as a global pandemic disease that affects mortality, morbidity, and economic recession worldwide including Myanmar. This study is aimed at investigating the prevalence and temporal nature of gastrointestinal and hepatic manifestations as well as their association with composite clinical endpoints in patients with COVID-19. Method. This was a retrospective hospital-based cohort study conducted on confirmed COVID-19 patients who were admitted to two designated COVID-19 hospitals: DSLH and No. (22/100) MH, Yangon, Myanmar, from June 1, 2021, to August 31, 2021. Data related to patients’ demographics, clinical characteristics, and clinical outcomes were abstracted manually through individual hospital records. Results. Out of the 241 patients recruited, 68 (28.2%) of the patients had GI symptoms. Ageusia/hypogeusia and diarrhea are the most common symptoms at 41.3% and 28.3%, respectively. Abnormal liver chemistries at admission are found in 52.7% of total patients. Mortality is 12.9% (31/241). Patients with abnormal liver chemistry are older ( p < 0.001 ), unvaccinated or incompletely vaccinated ( p = 0.04 ), associated comorbidities ( p = 0.019 ), leukocytosis ( p < 0.001 ), lymphopenia ( p = 0.033 ), hypoalbuminemia ( p < 0.001 ), higher INR ( p < 0.001 ), and longer HDU stay ( p < 0.001 ) and higher mortality ( p < 0.001 ). Conclusion. COVID-19-infected patients with abnormal liver chemistry are found to have worse clinical outcomes, although no significant association is found in patients with digestive symptoms. More attention should be given to this group of patients in the next coming wave.

Correlation between Total Lymphocyte Count, C Reactive Protein, and Neutrophil Lymphocyte Ratio Levels with Gastrointestinal Manifestations in Covid-19 Patients Treated at Ulin Hospital, Banjarmasin

“…(1) GI symptoms in COVID-19 patients in this study may not be related to inflammatory reactions and organ dysfunction [17]; (2) There is a correlation between decreased lymphocyte levels in younger COVID-19 patients as compared to older patients [18]. There is a theory that aging of the immune system can contribute to a "non-reactive" state of the immune system, thereby causing a relative decrease in the number of stable lymphocytes, while in younger populations, the decline in highly active lymphocytes can be influenced by several factors, thus contributing to a relatively higher average difference between younger populations [5]; (3) A meta-analysis study by Huang and Pranata showed that lymphopenia is associated with severe COVID-19.…”