Factors Associated with the Development of Gastrointestinal Symptoms in Patients Hospitalized with Covid-19

doi:10.1007/s10620-021-07286-7

Factors Associated with the Development of Gastrointestinal Symptoms in Patients Hospitalized with Covid-19

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

Background and Aims: The most common symptoms of Covid-19 are respiratory; however, gastrointestinal symptoms are present in up to 50% of patients. We aimed to determine characteristics associated with the development of gastrointestinal symptoms in patients with Covid-19. Methods: A case–control study of adults hospitalized for Covid-19 was conducted across a geographically diverse alliance of 36 US and Canadian medical centers. Data were manually abstracted from electronic health records and analyzed using regression analyses to determine characteristics associated with any gastrointestinal symptoms and diarrhea specifically. Results: Of 1406 patients, 540 (38%) reported at least one gastrointestinal symptom and 346 (25%) reported diarrhea. Older patients (≥ 80 years) had significantly lower rates of any gastrointestinal symptoms and diarrhea (vs. patients 18–79 years, OR 0.41, p < 0.01 and OR 0.43 p = 0.01, respectively), while those with IBS (OR 7.70, p = 0.02 and OR 6.72, p < 0.01, respectively) and on immunosuppressive therapy (OR = 1.56, p = 0.02) had higher rates of any gastrointestinal symptom and diarrhea. Patients with constitutional symptoms exhibited significantly higher rates (OR 1.91, p < 0.01), while those with pulmonary disease alone had lower rates of gastrointestinal symptoms (OR 0.23, p = 0.01). A significant interaction between constitutional symptoms and pre-existing pulmonary conditions was observed. Conclusions: Several patient- and disease-specific characteristics associate with gastrointestinal symptoms in patients with Covid-19. Knowledge of these may provide insights into associated pathophysiologic mechanisms, and help health care professionals provide targeted attention to reduce morbidity related to Covid-19.

Original language	English
Pages (from-to)	3860-3871
Number of pages	12
Journal	Digestive Diseases and Sciences
Volume	67
Issue number	8
DOIs	https://doi.org/10.1007/s10620-021-07286-7
State	Published - Aug 1 2022

Bibliographical note

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Funding

This research is not sponsored by any government or private sponsoring agency or institution. Writing committee: Olga C. Aroniadis MD MSc, Xianling Wang, Tang Gong, Nauzer Forbes MD MSc, Jeong Yun Yang MD, Andrew Canakis DO, B. Joseph Elmunzer MD MSc, Dhiraj Yadav, MD, MPH. Steering Committee: B. Joseph Elmunzer MD (Chair), Rebecca L. Spitzer MPH, Rebekah E. Dixon BS, Collins O. Ordiah MBBS, Jennifer M. Kolb MD, MS, Sachin Wani MD, Olga C. Aroniadis MD, MSc, Robin B. Mendelsohn MD, Christopher J. DiMaio MD, Don C. Rockey MD, Amit G. Singal MD, MS, Amar R. Deshpande MD, Swati Pawa MD, Darwin L. Conwell MD, MSc, Raman Muthusamy MD, MAS, William M. Tierney MD, Dhiraj Yadav MD, MPH. Statisticians: Xianling Wang, Tang Gong. Data Coordinating Center: Teldon B. Alford BA, Lauren Wakefield MHA, Haley Nitchie MHA, Collins O. Ordiah MBBS, Rebecca L. Spitzer MPH. Emory University: Ambreen A. Merchant MBBS, Vaishali A. Patel MD, Field F. Willingham MD, MPH. Vanderbilt University: Eric F. Howard RN, BSN, Mary K. West RN, BSN, Casey L Koza BS, Patrick S. Yachimski MD. Grady Memorial Hospital: Emad Qayed MD, MPH, Rosemary Nustas MD. Ascension Providence Hospital/Michigan State University: Ali Zakaria MD, Marc S. Piper MD, MSc. Saint Louis University: Jason R. Taylor MD, Lujain Jaza MD. University of Calgary: Nauzer Forbes MD, MSc, Millie Chau BSc. The Ohio State University Wexner Medical Center: Luis F. Lara MD, Georgios I. Papachristou MD, PhD, Uchechi Okafor BSc, Darwin L. Conwell MD, MSc. Loma Linda University: Michael L. Volk MD, MSc, Evan Mosier MD, Mohamed Azab MD, Anish Patel MD. University of Southern California: Liam G. Hilson MD, Selena Zhou MD, James Buxbaum MD. Washington University School of Medicine: Vladimir M. Kushnir MD, Alexandria M. Lenyo BS, Ian P. Sloan BS, Thomas Hollander RN, BSN. Medical University of South Carolina: Caroline G. McLeod BS, Rebecca L. Spitzer MPH, Lauren Wakefield MHA, Haley Nitchie MHA, Collins O. Ordiah MBBS, MPH, Don C. Rockey MD, B. Joseph Elmunzer MD. University of Miami Miller School of Medicine: Sunil Amin MD, MPH, Gabriela N. Kuftinec MD, MPH, Amar R. Deshpande MD. University of Pittsburgh: Dhiraj Yadav MD, MPH, Melissa Saul MS, Melanie Mays BS, Gulsum Anderson PhD, Kelley Wood BS, Laura Mathews BS, Xianling Wang, Tang Gong. University of Colorado: Charlie Fox MD, Jennifer M. Kolb MD, MS, Sachin Wani MD. Wake Forest University School of Medicine: Swati Pawa MD, Rishi Pawa MD. Boston University: Andrew Canakis DO, Christopher Huang MD. Beaumont Health: Laith H. Jamil MD, Andrew M. Aneese MD, V. Mihajlo Gjeorgjievski, MD, Zaid Imam MD, Fadi Odish MD, Ahmed I. Edhi MD, Molly Orosey DO, Abhinav Tiwari MD, Soumil Patwardhan MBBS. University Hospitals of Cleveland Medical Center: Benita K. Glamour BA, Zachary L Smith DO, Amy E. Hosmer MD, Nancy Furey RN, BSN, MBA, Amitabh Chak MD. Northwestern University: Feinberg School of Medicine: Katherine A. Hanley MMS, PAC, Jordan Wood BS, Rajesh N. Keswani MD, MS. Ochsner Health: Harsh K. Patel MBBS, Janak N. Shah MD. Columbia University Medical Center: Emil Agarunov BS, Nicholas G. Brown MD, Anish A. Patel MD, Amrita Sethi MD. Indiana University School of Medicine: Evan L. Fogel MD, MSc, Gail McNulty RN, BSN. Loyola University Medical Center: Abdul Haseeb MD, Judy A. Trieu MD. Icahn School of Medicine at Mount Sinai: Rebekah E. Dixon BS, Jeong Yun Yang MD, Christopher J. DiMaio MD. Memorial Sloan Kettering Cancer Center: Robin B. Mendelsohn MD, Delia Calo MD. Renaissance School of Medicine at Stony Brook University: Olga C. Aroniadis MD, MSc, Joseph F. LaComb BS, Lilian Cruz BS, Olga Reykhart BS. University of Virginia Medical School: James M. Scheiman MD, Bryan G. Sauer MD, Galina Diakova MS. Henry Ford Health System: Duyen T. Dang MD, Cyrus R. Piraka MD. Dartmouth-Hitchcock Health and VA White River Junction: Eric D. Shah MD, MBA, Molly Caisse BS, Natalia H. Zbib MD, John A. Damianos MD, Heiko Pohl MD. University of Oklahoma Health Sciences Center: William M. Tierney MD, Stephanie Mitchell RN, Michael S. Bronze MD. David Geffen School of Medicine at UCLA: Ashwinee Condon MD, Adrienne Lenhart MD, Raman Muthusamy MD, MAS. Medical College of Wisconsin: Kulwinder S. Dua MD, Vikram S. Kanagala MD, James Esteban MD. Johns Hopkins Medical Institutions: Ayesha Kamal MD, Marcia I. Canto MD, Vikesh K. Singh MD, MS. McMaster University Hamilton Health Sciences: Maria Ines Pinto-Sanchez MD, MSc, Joy M. Hutchinson RD, MSc. Michigan Medicine: Richard S. Kwon MD, Sheryl J. Korsnes MA. University of Manitoba: Harminder Singh MD, MPH, Zahra Solati MSc, Nick Hajidiacos MD.

Funders	Funder number
Haley Nitchie MHA
Lauren Wakefield MHA
MPH
University of California, Los Angeles
University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh
University Oklahoma Health Sciences Center
Virginia Agricultural Experiment Station, Virginia Polytechnic Institute and State University
University of Colorado Hospital Denver
Indiana University School of Medicine
University of Manitoba

Keywords

Characteristics
Covid-19
Gastrointestinal symptoms

ASJC Scopus subject areas

Physiology
Gastroenterology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1007/s10620-021-07286-7

Cite this

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title = "Factors Associated with the Development of Gastrointestinal Symptoms in Patients Hospitalized with Covid-19",

abstract = "Background and Aims: The most common symptoms of Covid-19 are respiratory; however, gastrointestinal symptoms are present in up to 50% of patients. We aimed to determine characteristics associated with the development of gastrointestinal symptoms in patients with Covid-19. Methods: A case–control study of adults hospitalized for Covid-19 was conducted across a geographically diverse alliance of 36 US and Canadian medical centers. Data were manually abstracted from electronic health records and analyzed using regression analyses to determine characteristics associated with any gastrointestinal symptoms and diarrhea specifically. Results: Of 1406 patients, 540 (38%) reported at least one gastrointestinal symptom and 346 (25%) reported diarrhea. Older patients (≥ 80 years) had significantly lower rates of any gastrointestinal symptoms and diarrhea (vs. patients 18–79 years, OR 0.41, p < 0.01 and OR 0.43 p = 0.01, respectively), while those with IBS (OR 7.70, p = 0.02 and OR 6.72, p < 0.01, respectively) and on immunosuppressive therapy (OR = 1.56, p = 0.02) had higher rates of any gastrointestinal symptom and diarrhea. Patients with constitutional symptoms exhibited significantly higher rates (OR 1.91, p < 0.01), while those with pulmonary disease alone had lower rates of gastrointestinal symptoms (OR 0.23, p = 0.01). A significant interaction between constitutional symptoms and pre-existing pulmonary conditions was observed. Conclusions: Several patient- and disease-specific characteristics associate with gastrointestinal symptoms in patients with Covid-19. Knowledge of these may provide insights into associated pathophysiologic mechanisms, and help health care professionals provide targeted attention to reduce morbidity related to Covid-19.",

keywords = "Characteristics, Covid-19, Gastrointestinal symptoms",

author = "Aroniadis, {Olga C.} and Xianling Wang and Tang Gong and Nauzer Forbes and Yang, {Jeong Yun} and Andrew Canakis and Elmunzer, {Badih Joseph} and Dhiraj Yadav and Aroniadis, {Olga C.} and Elmunzer, {B. Joseph} and Elmunzer, {B. Joseph} and Spitzer, {Rebecca L.} and Dixon, {Rebekah E.} and Ordiah, {Collins O.} and Kolb, {Jennifer M.} and Sachin Wani and Aroniadis, {Olga Olga C.} and Mendelsohn, {Robin B.} and DiMaio, {Christopher J.} and Rockey, {Don C.} and Singal, {Amit G.} and Deshpande, {Amar R.} and Swati Pawa and Conwell, {Darwin L.} and Raman Muthusamy and Tierney, {William M.} and Alford, {Teldon B.} and Lauren Wakefield and Haley Nitchie and Ordiah, {Collins O.} and Spitzer, {Rebecca L.} and Merchant, {Ambreen A.} and Patel, {Vaishali A.} and Willingham, {Field F.} and Howard, {Eric F.} and West, {Mary K.} and Koza, {Casey L.} and Yachimski, {Patrick S.} and Emad Qayed and Rosemary Nustas and Ali Zakaria and Piper, {Marc S.} and Taylor, {Jason R.} and Lujain Jaza and Millie Chau and Lara, {Luis F.} and Papachristou, {Georgios I.} and Uchechi Okafor and Volk, {Michael L.} and Evan Mosier",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2022",

month = aug,

day = "1",

doi = "10.1007/s10620-021-07286-7",

language = "English",

volume = "67",

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T1 - Factors Associated with the Development of Gastrointestinal Symptoms in Patients Hospitalized with Covid-19

AU - Aroniadis, Olga C.

AU - Wang, Xianling

AU - Gong, Tang

AU - Forbes, Nauzer

AU - Yang, Jeong Yun

AU - Canakis, Andrew

AU - Elmunzer, Badih Joseph

AU - Yadav, Dhiraj

AU - Aroniadis, Olga C.

AU - Elmunzer, B. Joseph

AU - Spitzer, Rebecca L.

AU - Dixon, Rebekah E.

AU - Ordiah, Collins O.

AU - Kolb, Jennifer M.

AU - Wani, Sachin

AU - Aroniadis, Olga Olga C.

AU - Mendelsohn, Robin B.

AU - DiMaio, Christopher J.

AU - Rockey, Don C.

AU - Singal, Amit G.

AU - Deshpande, Amar R.

AU - Pawa, Swati

AU - Conwell, Darwin L.

AU - Muthusamy, Raman

AU - Tierney, William M.

AU - Alford, Teldon B.

AU - Wakefield, Lauren

AU - Nitchie, Haley

AU - Ordiah, Collins O.

AU - Spitzer, Rebecca L.

AU - Merchant, Ambreen A.

AU - Patel, Vaishali A.

AU - Willingham, Field F.

AU - Howard, Eric F.

AU - West, Mary K.

AU - Koza, Casey L.

AU - Yachimski, Patrick S.

AU - Qayed, Emad

AU - Nustas, Rosemary

AU - Zakaria, Ali

AU - Piper, Marc S.

AU - Taylor, Jason R.

AU - Jaza, Lujain

AU - Chau, Millie

AU - Lara, Luis F.

AU - Papachristou, Georgios I.

AU - Okafor, Uchechi

AU - Volk, Michael L.

AU - Mosier, Evan

PY - 2022/8/1

Y1 - 2022/8/1

N2 - Background and Aims: The most common symptoms of Covid-19 are respiratory; however, gastrointestinal symptoms are present in up to 50% of patients. We aimed to determine characteristics associated with the development of gastrointestinal symptoms in patients with Covid-19. Methods: A case–control study of adults hospitalized for Covid-19 was conducted across a geographically diverse alliance of 36 US and Canadian medical centers. Data were manually abstracted from electronic health records and analyzed using regression analyses to determine characteristics associated with any gastrointestinal symptoms and diarrhea specifically. Results: Of 1406 patients, 540 (38%) reported at least one gastrointestinal symptom and 346 (25%) reported diarrhea. Older patients (≥ 80 years) had significantly lower rates of any gastrointestinal symptoms and diarrhea (vs. patients 18–79 years, OR 0.41, p < 0.01 and OR 0.43 p = 0.01, respectively), while those with IBS (OR 7.70, p = 0.02 and OR 6.72, p < 0.01, respectively) and on immunosuppressive therapy (OR = 1.56, p = 0.02) had higher rates of any gastrointestinal symptom and diarrhea. Patients with constitutional symptoms exhibited significantly higher rates (OR 1.91, p < 0.01), while those with pulmonary disease alone had lower rates of gastrointestinal symptoms (OR 0.23, p = 0.01). A significant interaction between constitutional symptoms and pre-existing pulmonary conditions was observed. Conclusions: Several patient- and disease-specific characteristics associate with gastrointestinal symptoms in patients with Covid-19. Knowledge of these may provide insights into associated pathophysiologic mechanisms, and help health care professionals provide targeted attention to reduce morbidity related to Covid-19.

AB - Background and Aims: The most common symptoms of Covid-19 are respiratory; however, gastrointestinal symptoms are present in up to 50% of patients. We aimed to determine characteristics associated with the development of gastrointestinal symptoms in patients with Covid-19. Methods: A case–control study of adults hospitalized for Covid-19 was conducted across a geographically diverse alliance of 36 US and Canadian medical centers. Data were manually abstracted from electronic health records and analyzed using regression analyses to determine characteristics associated with any gastrointestinal symptoms and diarrhea specifically. Results: Of 1406 patients, 540 (38%) reported at least one gastrointestinal symptom and 346 (25%) reported diarrhea. Older patients (≥ 80 years) had significantly lower rates of any gastrointestinal symptoms and diarrhea (vs. patients 18–79 years, OR 0.41, p < 0.01 and OR 0.43 p = 0.01, respectively), while those with IBS (OR 7.70, p = 0.02 and OR 6.72, p < 0.01, respectively) and on immunosuppressive therapy (OR = 1.56, p = 0.02) had higher rates of any gastrointestinal symptom and diarrhea. Patients with constitutional symptoms exhibited significantly higher rates (OR 1.91, p < 0.01), while those with pulmonary disease alone had lower rates of gastrointestinal symptoms (OR 0.23, p = 0.01). A significant interaction between constitutional symptoms and pre-existing pulmonary conditions was observed. Conclusions: Several patient- and disease-specific characteristics associate with gastrointestinal symptoms in patients with Covid-19. Knowledge of these may provide insights into associated pathophysiologic mechanisms, and help health care professionals provide targeted attention to reduce morbidity related to Covid-19.

KW - Characteristics

KW - Covid-19

KW - Gastrointestinal symptoms

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DO - 10.1007/s10620-021-07286-7

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SN - 0163-2116

VL - 67

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EP - 3871

JO - Digestive Diseases and Sciences

JF - Digestive Diseases and Sciences

IS - 8

ER -

Factors Associated with the Development of Gastrointestinal Symptoms in Patients Hospitalized with Covid-19

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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