ABSTRACT
Introduction: gastrointestinal involvement in COVID-19 occurs in approximately 20% of patients and may include nausea, vomiting, abdominal pain, diarrhea or abnormal liver function tests. In our country, the characteristics of gastrointestinal involvement in COVID-19 patients have not been studied. Objectives: to determine the prevalence of gastrointestinal and liver involvement in patients with COVID-19 treated at two hospitals in Bogotá, Colombia. To determine the association between COVID-19 gastrointestinal involvement and length of hospital stay, severity and mortality. Design and methodology: a cross-sectional study carried out at two hospitals in a hospital subnetwork in Bogotá, Colombia from February 2020 to March 2021. Results: a total of 1,176 patients with a positive reverse transcription polymerase chain reaction (RT-PCR) were included. Gastrointestinal manifestations occurred in 50% (95%CI 47-52%), with the most frequent being diarrhea in 18.4%, odynophagia in 17.6%, anorexia in 14.7% and abdominal pain in 8.8%. An association was found between diarrhea during hospitalization and prolonged hospitalization (OR 1.93 95%CI 1.19-3.13), and between gastrointestinal bleeding on admission and death (OR 3.13, 95%CI 1.1-9.1), among others. Abnormal liver function tests occurred in 46% (95%CI 43-49%) and were more frequent in patients with severe disease and those who died. Conclusions: the prevalence of gastrointestinal manifestations in patients with COVID-19 was 50%. Diarrhea was associated with a longer hospital stay, and gastrointestinal bleeding was associated with respiratory failure and death. Forty-six percent of patients had abnormal liver function tests, with elevated transaminases being the most frequent. Elevated aspartate transaminase (AST) on admission was associated with greater mortality. (Acta Med Colomb 2022; 48. DOI:https://doi.org/10.36104/amc.2023.2729).
ABSTRACT
El amitraz es un insecticida utilizado en el control de plagas, el cual corresponde a un agonista adrenérgico central y periférico, cuya naturaleza aromática altamente lipofílica le permite una amplia absorción por cualquier vía de administración. Presentamos el caso clínico de un paciente de 35 años de edad, atendido en el servicio de urgencias después de la ingesta de 50 ml de Startox® (amitraz). Ingresa con somnolencia, bradicardia, hipotensión, pupilas mióticas, hiperglicemia y acidosis metabólica, por lo que se brindan medidas iniciales de soporte vital, con posterior vigilancia cardiorrespiratoria en la Unidad de Cuidados Intensivos. El cuadro refleja la proximidad clínica de la intoxicación por amitraz y la causada por otros tóxicos, en especial organofosforados y carbamatos..(AU)
Amitraz is an insecticide used in the control of pests, which corresponds to a central and peripheral drenergic agonist whose highly lipophilic aromatic nature allows a broad absorption by any route of administration. We present the clinical case of a 35-year-old patient treated in the emergency department after the intake of 50 ml of Startox® (amitraz). She enters with drowsiness, bradycardia, hypotension, miotic pupils, hyperglycemia and metabolic acidosis, so initial measures of life support are provided, with subsequent cardiorespiratory monitoring in the Intensive Care Unit. The table reflects the clinical proximity of amitraz poisoning and that caused by other toxicants, especially organophosphates and carbamates..(AU)