Digestive Manifestations in Patients Hospitalized With Coronavirus Disease 2019

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29 Scopus citations

Abstract

Background & Aims: The prevalence and significance of digestive manifestations in coronavirus disease 2019 (COVID-19) remain uncertain. We aimed to assess the prevalence, spectrum, severity, and significance of digestive manifestations in patients hospitalized with COVID-19. Methods: Consecutive patients hospitalized with COVID-19 were identified across a geographically diverse alliance of medical centers in North America. Data pertaining to baseline characteristics, symptomatology, laboratory assessment, imaging, and endoscopic findings from the time of symptom onset until discharge or death were abstracted manually from electronic health records to characterize the prevalence, spectrum, and severity of digestive manifestations. Regression analyses were performed to evaluate the association between digestive manifestations and severe outcomes related to COVID-19. Results: A total of 1992 patients across 36 centers met eligibility criteria and were included. Overall, 53% of patients experienced at least 1 gastrointestinal symptom at any time during their illness, most commonly diarrhea (34%), nausea (27%), vomiting (16%), and abdominal pain (11%). In 74% of cases, gastrointestinal symptoms were judged to be mild. In total, 35% of patients developed an abnormal alanine aminotransferase or total bilirubin level; these were increased to less than 5 times the upper limit of normal in 77% of cases. After adjusting for potential confounders, the presence of gastrointestinal symptoms at any time (odds ratio, 0.93; 95% CI, 0.76–1.15) or liver test abnormalities on admission (odds ratio, 1.31; 95% CI, 0.80–2.12) were not associated independently with mechanical ventilation or death. Conclusions: Among patients hospitalized with COVID-19, gastrointestinal symptoms and liver test abnormalities were common, but the majority were mild and their presence was not associated with a more severe clinical course.

Original languageEnglish
Pages (from-to)1355-1365.e4
JournalClinical Gastroenterology and Hepatology
Volume19
Issue number7
DOIs
StatePublished - Jul 2021

Bibliographical note

Funding Information:
Badih Joseph Elmunzer, MD (Conceptualization: Lead; Data curation: Lead; Formal analysis: Lead; Supervision: Lead; Writing — original draft: Lead), Rebecca L. Spitzer (Data curation: Supporting; Formal analysis: Supporting; Project administration: Lead; Writing — review & editing: Equal), Lydia D. Foster (Formal analysis: Lead; Writing — review & editing: Equal), Ambreen A. Merchant (Data curation: Equal; Writing — review & editing: Equal), Eric F. Howard (Data curation: Equal; Writing — review & editing: Equal), Vaishali A. Patel (Data curation: Supporting; Writing — review & editing: Equal), Mary K. West (Data curation: Equal; Writing — review & editing: Equal), Emad Qayad (Data curation: Equal; Investigation: Equal; Writing — review & editing: Equal), Rosemary Nustas (Data curation: Supporting; Writing — review & editing: Equal), Ali Zakaria (Data curation: Equal; Writing — review & editing: Equal), Marc S. Piper (Data curation: Equal; Writing — review & editing: Equal), Jason R. Taylor (Data curation: Equal; Investigation: Equal; Writing — review & editing: Equal), Lujain Jaza (Data curation: Equal; Writing — review & editing: Equal), Nauzer Forbes (Data curation: Supporting; Investigation: Equal; Writing — review & editing: Equal), Millie Chau (Data curation: Equal; Writing — review & editing: Equal), Luis F. Lara (Data curation: Equal; Investigation: Equal; Writing — review & editing: Equal), Georgios I. Papachristou (Data curation: Equal; Investigation: Equal; Writing — review & editing: Equal), Michael L. Volk (Data curation: Supporting; Investigation: Equal; Writing — review & editing: Equal), Liam G. Hilson (Data curation: Equal; Writing — review & editing: Equal), Selena Zhou (Data curation: Supporting; Writing — review & editing: Equal), Vladimir M. Kushnir (Data curation: Supporting; Investigation: Equal; Writing — review & editing: Equal), Alexandria M. Lenyo (Data curation: Equal; Writing — review & editing: Equal), Caroline G. McLeod (Data curation: Equal; Writing — review & editing: Equal), Sunil Amin (Data curation: Equal; Writing — review & editing: Equal), Gabriela N. Kuftinec (Data curation: Equal; Writing — review & editing: Equal), Dhiraj Yadav (Data curation: Supporting; Investigation: Equal; Writing — review & editing: Equal), Charlie Fox (Data curation: Equal; Writing — review & editing: Equal), Jennifer M. Kolb (Data curation: Equal; Writing — review & editing: Equal), Swati Pawa (Data curation: Equal; Investigation: Equal; Writing — review & editing: Equal), Rishi Pawa (Data curation: Supporting; Writing — review & editing: Equal), Andrew Canakis (Data curation: Equal; Writing — review & editing: Equal), Christopher Huang (Data curation: Supporting; Writing — review & editing: Equal), Laith H. Jamil (Data curation: Supporting; Investigation: Equal; Writing — review & editing: Equal), Andrew M. Aneese (Data curation: Equal; Writing — review & editing: Equal), Benita K. Glamour (Data curation: Equal; Writing — review & editing: Equal), Zachary L. Smith (Data curation: Supporting; Investigation: Equal; Writing — review & editing: Equal), Katherine A. Hanley (Data curation: Equal; Writing — review & editing: Equal), Jordan Wood (Data curation: Equal; Writing — review & editing: Equal), Harsh K. Patel (Data curation: Equal; Writing — review & editing: Equal), Janak N. Shah (Data curation: Supporting; Writing — review & editing: Equal), Emil Agarunov (Data curation: Equal; Writing — review & editing: Equal), Amrita Sethi (Data curation: Equal; Writing — review & editing: Equal), Evan L. Fogel (Data curation: Supporting; Investigation: Equal; Writing — review & editing: Equal), Gail McNulty (Data curation: Equal; Writing — review & editing: Equal), Abdul Haseeb (Data curation: Equal; Writing — review & editing: Equal), Judy A. Trieu (Data curation: Equal; Writing — review & editing: Equal), Rebekah E. Dixon (Data curation: Equal; Writing — review & editing: Equal), Jeong Yun Yang (Data curation: Equal; Writing — review & editing: Equal), Robin B. Mendelsohn (Data curation: Equal; Investigation: Equal; Writing — review & editing: Equal), Delia Calo (Data curation: Equal; Writing — review & editing: Equal), Olga C. Aroniadis (Data curation: Equal; Writing — review & editing: Equal), Joseph F. LaComb (Data curation: Equal; Writing — review & editing: Equal), James M. Scheiman (Data curation: Supporting; Investigation: Equal; Writing — review & editing: Equal), Bryan G. Sauer (Data curation: Supporting; Writing — review & editing: Equal), Duyen T. Dang (Data curation: Equal; Writing — review & editing: Equal), Cyrus R. Piraka (Data curation: Supporting; Investigation: Equal; Writing — review & editing: Equal), Eric D. Shah (Data curation: Equal; Writing — review & editing: Equal), Heiko Pohl (Data curation: Equal; Investigation: Equal; Writing — review & editing: Equal), William M. Tierney (Data curation: Supporting; Investigation: Equal; Writing — review & editing: Equal), Stephanie Mitchell (Data curation: Equal; Writing — review & editing: Equ

Publisher Copyright:
© 2021 AGA Institute

Keywords

  • COVID-19
  • Digestive Manifestations
  • Gastrointestinal Symptoms
  • Hepatic Manifestations
  • SARS-CoV-2

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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