ABSTRACT
Background: Various digestive symptoms caused by COVID-19 are frequently reported. This study aims to describe the most frequent digestive signs in patients with COVID-19, the relationship between the severity of digestive symptoms and some serological markers associated with liver manifestation, the detection of SARS-CoV-2 in a stool sample, and the mortality rate of those patients. Material(s) and Method(s): A descriptive cross-sectional study on 100 confirmed COVID-19 cases with digestive and hepatic manifestation in one center (Fallujah Teaching Hospital), Anbar governorate, Iraq, during a period of study. Questioner's data were formed for all patients regarding age, sex, and comorbidities such as diabetes and hypertension. Liver function enzymes such as alanine aminotransferase (ALT), aspartate aminotransferase, alkaline phosphatase, total bilirubin (TBIL), and direct bilirubin and haematological parameters such as ferritin D-dimer, C-reactive protein (CRP), albumin, amylase, leukocyte count, and prothrombin time were used. SARS-CoV-2 prevalence in stool is determined using reverse transcription polymerase chain reaction according to manufacturer's instructions. The mortality rate of patients with COVID-19 was also determined. Data were followed up until April 22, 2022. Result(s): Patients with digestive symptoms who had COVID-19 had an average age of 45.03 (SD 20.078), 52 (52%) were men, and 48 (48%) were women. No statistically significant variances were observed in the severity of digestive symptoms among age groups. The three digestive symptoms that patients with COVID-19 experienced most frequently were fatigue, fever, and abdominal colic. SARS-CoV-2 was detected in the stool of 11% of the patients with COVID-19 with digestive signs. The COVID-19 mortality rate was 9%. Statistically, significant variance was observed in ALT (P value 0.01) and TBIL (P value 0.0027) levels between mild, moderate, and severe gastrointestinal (GI) diseases. The levels of CRP varied considerably among those with mild, moderate, and severe GI conditions (P value 0.0182, according to the findings). In mild, moderate, and severe GI disorders, ferritin levels differed considerably (P value 0.05). Conclusion(s): The faecal sample with a nasopharyngeal swab is needed to confirm COVID-19 diagnosis;hepatic manifestations are connected with increased COVID-19 mortality in individuals with digestive symptoms.Copyright © 2022 Wahab, Khalil, Majeed, licensee HBKU Press.
ABSTRACT
Background: Abnormalities in liver function tests (LFTs) are found in 14%-53% of hospitalized COVID-19 patients. These could occur in patients with or without previous chronic liver diseases. Knowing the risk factor of liver manifestations in COVID-19 subjects is crucial for the proper management of these patients. Objective(s): We aimed to identify the risk factors for liver manifestations as well as other risk factors in COVID-19 subjects who complained of digestive manifestations. Material(s) and Method(s): COVID-19 patients with and without liver manifestations at the Emergency Department of Al Fallujah Teaching Hospital were enrolled in this study. This study covered a period from September 15, 2022, to April 22, 2022. Comparisons between patients with or without abnormal LFTs were made. The possible risk variables connected to abnormal LFTs and hepatic manifestation were investigated using univariable and multivariable logistic regression analysis. Result(s): Out of 100 COVID-19 patients, there were 64 suffering from mild gastrointestinal (GI) symptoms. There were 26 mild cases with abnormal LFTs (40.6%). Although there were nine (total number 22) and seven (total number 14) of the moderate and severe cases with liver involvement, there was no statistically significant difference between the digestive manifestations severity and liver involvement. Increased alanine aminotransferase (ALT) levels were linked to a greater incidence of LFTs, according to multivariable analysis (odds ratio [OR]: 45.05;P < 0.0001), elevated aspartate aminotransferase (AST;OR: 3.462;P = 0.00041), elevated direct bilirubin (DBIL) (OR: 3.643;P < 0.001), and elevated d-dimer levels [OR]: 2.690;P < 0.0137) in liver involvement group compared with non-involvement patients. Conclusion(s): Elevated ALT, AST, DBIL, and d-dimer are potential risk factors for liver manifestations in COVID-19 patients with digestive symptoms.
ABSTRACT
Background: Various digestive symptoms caused by COVID-19 are frequently reported. This study aims to describe the most frequent digestive signs in patients with COVID-19, the relationship between the severity of digestive symptoms and some serological markers associated with liver manifestation, the detection of SARS-CoV-2 in a stool sample, and the mortality rate of those patients. Material(s) and Method(s): A descriptive cross-sectional study on 100 confirmed COVID-19 cases with digestive and hepatic manifestation in one center (Fallujah Teaching Hospital), Anbar governorate, Iraq, during a period of study. Questioner's data were formed for all patients regarding age, sex, and comorbidities such as diabetes and hypertension. Liver function enzymes such as alanine aminotransferase (ALT), aspartate aminotransferase, alkaline phosphatase, total bilirubin (TBIL), and direct bilirubin and haematological parameters such as ferritin D-dimer, Creactive protein (CRP), albumin, amylase, leukocyte count, and prothrombin time were used. SARS-CoV-2 prevalence in stool is determined using reverse transcription polymerase chain reaction according to manufacturer's instructions. The mortality rate of patients with COVID-19 was also determined. Data were followed up until April 22, 2022. Result(s): Patients with digestive symptoms who had COVID-19 had an average age of 45.03 (SD 20.078), 52 (52%) were men, and 48 (48%) were women. No statistically significant variances were observed in the severity of digestive symptoms among age groups. The three digestive symptoms that patients with COVID-19 experienced most frequently were fatigue, fever, and abdominal colic. SARS-CoV-2 was detected in the stool of 11% of the patients with COVID-19 with digestive signs. The COVID-19 mortality rate was 9%. Statistically, significant variance was observed in ALT (P value 0.01) and TBIL (P value 0.0027) levels between mild, moderate, and severe gastrointestinal (GI) diseases. The levels of CRP varied considerably among those with mild, moderate, and severe GI conditions (P value 0.0182, according to the findings). In mild, moderate, and severe GI disorders, ferritin levels differed considerably (P value 0.05). Conclusion(s): The faecal sample with a nasopharyngeal swab is needed to confirm COVID-19 diagnosis;hepatic manifestations are connected with increased COVID-19 mortality in individuals with digestive symptoms.