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 fenómeno de Raynaud es una respuesta vascular exagerada al frío o al estrés que se manifiesta por cambios de coloración de la piel en diversas localizaciones; característicamente, presenta tres fases distintas que comprenden palidez, cianosis y rubor. Dependiendo de la ausencia o la presencia de enfermedad de base, el fenómeno se denomina como primario o secundario, siendo este último subtipo una manifestación importante de enfermedades graves, principalmente autoinmunes. El fenómeno de Raynaud primario tiene buen pronóstico y la posibilidad de manejo por médico primario; por el contrario, el secundario implica la necesidad de evaluación y manejo especializado. Es de importancia para el médico general conocer su clasificación, las bases del manejo para control de los signos y síntomas, además de identificar cuándo un paciente requiere valoración y manejo especializado de acuerdo con otras enfermedades de base que puedan coexistir.
Raynaud's phenomenon is an exaggerated vascular response to cold or stress manifested by skin colour changes at several locations, having three characteristic phases: pallor (white), cyanosis (blue) and rubor (red). When the cause is not known this phenomenon is termed primary Raynaud's phenomenon and secondary Raynaud's phenomenon when underlying disease is involved, autoimmune disease being the most frequent cause of the secondary form. Primary Raynaud's phenomenon has a good prognosis and can be treated medically without the need for specialist assessment, unlike secondary Raynaud's phenomenon which needs specialist assessment and treatment. A general practitioner needs to know the classification, the basis for treatment for signs and symptoms control and know when a patient requires specialist evaluation for treatment according to other diseases which may be present or coexist.