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3.
J Med Virol ; 94(4): 1315-1329, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1718396

ABSTRACT

In December 2019, novel severe acute respiratory syndrome coronavirus 2 (nSARS-CoV-2) virus outbreaks emerged from Wuhan, China, and spread all over the world, including India. Molecular diagnosis of Coronavirus Disease 2019 (COVID) 19 for densely and highly populated countries like India is time-consuming. A few reports have described the successful diagnosis of nSARS-CoV-2 virus from sewage and wastewater samples contaminated with fecal matter, suggesting the diagnosis of COVID 19 from the same to raise an alarm about the community transmission of virus for implementation of evacuation and lockdown strategies. So far, the association between the detection of virus and its concentration in stool samples with severity of the disease and the presence or absence of gastrointestinal symptoms have been rarely reported. We led the search utilizing multiple databases, specifically PubMed (Medline), EMBASE, and Google Scholar. We conducted a literature survey on gastrointestinal infection and the spread of this virus through fecal-oral transmission. Reports suggested that the existence and persistence of nSARS-CoV-2 in anal/rectal swabs and stool specimens for a longer period of time than in nasopharyngeal swabs provides a strong tenable outcome of gastrointestinal contamination and dissemination of this infection via potential fecal-oral transmission. This review may be helpful to conduct further studies to address the enteric involvement and excretion of nSARS-CoV-2 RNA in feces and control the community spread in both COVID-19 patients ahead of the onset of symptoms and in asymptomatic individuals through wastewater and sewage surveillance as an early indication of infection. The existence of the viral genome and active viral particle actively participate in genomic variations. Hence, we comprehended the enteric spread of different viruses amongst communities with special reference to nSARS-CoV-2.


Subject(s)
COVID-19/virology , Disease Transmission, Infectious , Gastrointestinal Diseases/virology , SARS-CoV-2/isolation & purification , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Disease Transmission, Infectious/prevention & control , Feces/virology , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/prevention & control , Gastrointestinal Tract/virology , Humans , India/epidemiology , SARS-CoV-2/genetics , Sewage/virology , Water Purification
4.
JAMA Netw Open ; 4(12): e2139974, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1589283

ABSTRACT

Importance: Severe gastrointestinal (GI) manifestations have been sporadically reported in children with COVID-19; however, their frequency and clinical outcome are unknown. Objective: To describe the clinical, radiological, and histopathologic characteristics of children with COVID-19 presenting with severe GI manifestations to identify factors associated with a severe outcome. Design, Setting, and Participants: A multicenter retrospective cohort study (February 25, 2020, to January 20, 2021) enrolled inpatient and outpatient children (aged <18 years) with acute SARS-CoV-2 infection, confirmed by positive real-time reverse-transcriptase-polymerase chain reaction on nasopharyngeal swab or fulfilling the US Centers for Disease Control and Prevention criteria for multisystem inflammatory syndrome in children (MIS-C). The study was conducted by pediatricians working in primary care or hospitals in Italy participating in the COVID-19 Registry of the Italian Society of Pediatric Infectious Diseases. Main Outcomes and Measures: The occurrence of severe GI manifestations, defined by a medical and/or radiological diagnosis of acute abdomen, appendicitis (complicated or not by perforation and/or peritonitis), intussusception, pancreatitis, abdominal fluid collection, and diffuse adenomesenteritis requiring surgical consultation, occurring during or within 4 to 6 weeks after infection with SARS-CoV-2 infection. Logistic regression was used to estimate odds ratios (ORs) with 95% CIs of factors potentially associated with severe outcomes. Results: Overall, 685 children (386 boys [56.4%]; median age, 7.3 [IQR, 1.6-12.4] years) were included. Of these children, 628 (91.7%) were diagnosed with acute SARS-CoV-2 infection and 57 (8.3%) with MIS-C. The presence of GI symptoms was associated with a higher chance of hospitalization (OR, 2.64; 95% CI, 1.89-3.69) and intensive care unit admission (OR, 3.90; 95% CI, 1.98-7.68). Overall, 65 children (9.5%) showed severe GI involvement, including disseminated adenomesenteritis (39.6%), appendicitis (33.5%), abdominal fluid collection (21.3%), pancreatitis (6.9%), or intussusception (4.6%). Twenty-seven of these 65 children (41.5%) underwent surgery. Severe GI manifestations were associated with the child's age (5-10 years: OR, 8.33; 95% CI, 2.62-26.5; >10 years: OR, 6.37; 95% CI, 2.12-19.1, compared with preschool-age), abdominal pain (adjusted OR [aOR], 34.5; 95% CI, 10.1-118), lymphopenia (aOR, 8.93; 95% CI, 3.03-26.3), or MIS-C (aOR, 6.28; 95% CI, 1.92-20.5). Diarrhea was associated with a higher chance of adenomesenteritis (aOR, 3.13; 95% CI, 1.08-9.12) or abdominal fluid collection (aOR, 3.22; 95% CI, 1.03-10.0). Conclusions and Relevance: In this multicenter cohort study of Italian children with SARS-CoV-2 infection or MIS-C, 9.5% of the children had severe GI involvement, frequently associated with MIS-C. These findings suggest that prompt identification may improve the management of serious complications.


Subject(s)
COVID-19/complications , Gastrointestinal Diseases/virology , Systemic Inflammatory Response Syndrome/complications , Child , Child, Preschool , Female , Gastrointestinal Diseases/diagnostic imaging , Gastrointestinal Diseases/pathology , Humans , Male , Prognosis , Radiography , Retrospective Studies , SARS-CoV-2
5.
J Gastroenterol Hepatol ; 37(3): 489-498, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1570817

ABSTRACT

BACKGROUND AND AIM: Because acute infectious gastroenteritis may cause post-infection irritable bowel syndrome and functional dyspepsia and the severe acute respiratory syndrome coronavirus-2 affects gastrointestinal (GI) tract, coronavirus disease-19 (COVID-19) may cause post-infection-functional GI disorders (FGIDs). We prospectively studied the frequency and spectrum of post-infection-FGIDs among COVID-19 and historical healthy controls and the risk factors for its development. METHODS: Two hundred eighty patients with COVID-19 and 264 historical healthy controls were followed up at 1 and 3 months using translated validated Rome Questionnaires for the development of chronic bowel dysfunction (CBD), dyspeptic symptoms, and their overlap and at 6-month for IBS, uninvestigated dyspepsia (UD) and their overlap. Psychological comorbidity was studied using Rome III Psychosocial Alarm Questionnaire. RESULTS: At 1 and 3 months, 16 (5.7%), 16 (5.7%), 11 (3.9%), and 24 (8.6%), 6 (2.1%), 9 (3.2%) of COVID-19 patients developed CBD, dyspeptic symptoms, and their overlap, respectively; among healthy controls, none developed dyspeptic symptoms and one developed CBD at 3 months (P < 0.05). At 6 months, 15 (5.3%), 6 (2.1%), and 5 (1.8%) of the 280 COVID-19 patients developed IBS, UD, and IBS-UD overlap, respectively, and one healthy control developed IBS at 6 months (P < 0.05 for all except IBS-UD overlap). The risk factors for post-COVID-19 FGIDs at 6 months included symptoms (particularly GI), anosmia, ageusia, and presence of CBD, dyspeptic symptoms, or their overlap at 1 and 3 months and the psychological comorbidity. CONCLUSIONS: This is the first study showing COVID-19 led to post-COVID-19 FGIDs. Post-COVID-19 FGIDs may pose a significant economic, social, and healthcare burden to the world.


Subject(s)
COVID-19 , Gastrointestinal Diseases , COVID-19/complications , COVID-19/epidemiology , Case-Control Studies , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/virology , Humans , Incidence , Prospective Studies , Risk Factors , SARS-CoV-2
6.
Am J Emerg Med ; 52: 184-186, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1568459

ABSTRACT

Return visits (RV) to a pediatric emergency department (PED) can be secondary to illness progression, parental concerns, call backs or rarely due to a diagnostic error during the first visit. Fever accounts for nearly half of these RVs and is also one of the most common presenting complaints of Corona Virus Disease 2019 (COVID- 19) due to severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection in children. Although majority of children with COVID 19 have a mild illness, severe complications such as Multisystem inflammatory syndrome in children (MIS-C) can occur. These children are often critically ill with a mortality rate of 2-4%. Initial symptoms of MIS- C are non- specific and mimic other viral illness making early diagnosis challenging. We report five patients who were evaluated for fever and discharged from our PED and were subsequently diagnosed with MIS-C (n = 3) or Kawasaki Disease (n = 2) during their RV within 7 days. All patients presented with fever during the initial visit and three of the five children had gastrointestinal symptoms. They were all noted have persistent tachycardia during the index visit. Three patients presented in cardiogenic shock and echocardiographic abnormalities were noted in four patients during the RV. Significant interventions were required in majority of these children (PICU admission: 4, inotropes: 3, mechanical ventilation:2). Clinicians need to maintain a high index of suspicion for diagnosis of MIS-C especially in those who present with persistent fever and have abnormal vital signs during the COVID-19 pandemic.


Subject(s)
COVID-19/complications , Emergency Service, Hospital , Fever/virology , Systemic Inflammatory Response Syndrome/complications , Adolescent , COVID-19/therapy , Child , Child, Preschool , Female , Gastrointestinal Diseases/virology , Humans , Infant , Male , Mitral Valve Insufficiency/virology , Pandemics , SARS-CoV-2 , Systemic Inflammatory Response Syndrome/therapy , Tachycardia/virology , Ventricular Dysfunction/virology
9.
World J Gastroenterol ; 27(37): 6345-6347, 2021 Oct 07.
Article in English | MEDLINE | ID: covidwho-1468514

ABSTRACT

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although, respiratory symptoms are typical the digestive system is also a susceptible target with gastrointestinal symptoms present even in the absence of respiratory symptoms. The gastrointestinal symptoms of COVID-19 include diarrhea, abdominal pain, anorexia, and nausea among other symptoms. Some questions that remain to be answered include: Do patients with gastrointestinal symptoms have a higher mortality? SARS-CoV-2 variants are already a global reality: Do these variants present with a greater prevalence of gastrointestinal symptoms? Do patients with these symptoms warrant more intensive care unit care?


Subject(s)
COVID-19 , Gastrointestinal Diseases , COVID-19/complications , Diarrhea/virology , Gastrointestinal Diseases/virology , Humans , SARS-CoV-2
10.
Front Immunol ; 12: 711741, 2021.
Article in English | MEDLINE | ID: covidwho-1430696

ABSTRACT

COVID-19 is widespread worldwide and seriously affects the daily life and health of humans. Countries around the world are taking necessary measures to curb the spread. However, COVID-19 patients often have at least one organ complication and sequelae in addition to respiratory symptoms. Controlling the epidemic is only a phased victory, and the complication and sequelae of COVID-19 will need more attention in the post-epidemic era. We collected general information from over 1000 articles published in 2020 after the COVID-19 outbreak and systematically analyzed the complication and sequelae associated with eight major systems in COVID-19 patients caused by ACE2 intervention in the RAS regulatory axis. The autoimmune response induced by 2019-nCoV attacks and damages the normal tissues and organs of the body. Our research will help medical workers worldwide address COVID-19 complication and sequelae.


Subject(s)
COVID-19/pathology , Cardiovascular Diseases/pathology , Endocrine System Diseases/pathology , Gastrointestinal Diseases/pathology , Nervous System Diseases/pathology , Urologic Diseases/pathology , COVID-19/complications , Cardiovascular Diseases/virology , Disease Outbreaks , Disease Progression , Endocrine System Diseases/virology , Gastrointestinal Diseases/virology , Humans , Nervous System Diseases/virology , SARS-CoV-2 , Urologic Diseases/virology
11.
Curr Opin Infect Dis ; 34(5): 471-476, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1408783

ABSTRACT

PURPOSE OF REVIEW: The ubiquitous expression of angiotensin-converting enzyme-2 receptors and its significance as the origin of viral entry have assisted in comprehending the pathophysiology of extrapulmonary manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this review, we focus on the clinical significance of gastrointestinal manifestations. RECENT FINDINGS: The global pandemic, a result of the widespread implications of SARS-CoV-2, remains a significant burden to current healthcare systems. Fever, dyspnea, and tussive symptoms have primarily been recognized as the most common presenting signs/symptoms. During the past one year our scope of practice has transcended beyond the management of the respiratory system to incorporate other varying systemic manifestations such as anorexia, nausea, vomiting, diarrhea, and abdominal pain. The outcomes reported by recent studies suggest an association between the presence of gastrointestinal symptoms and important clinical factors such as delay in presentation, disease severity, and mortality. SUMMARY: We provide a summarization of the most recent in-depth investigations of coronavirus disease 2019 with gastrointestinal manifestations and their conclusions. Although the pathophysiology remains an area of evolving interest, a better understanding of this disease process may allow for early recognition, efficient triage, and improved prognostication for those presenting with gastrointestinal manifestations of SARS-CoV-2.


Subject(s)
COVID-19/complications , COVID-19/pathology , Gastrointestinal Diseases/etiology , Gastrointestinal Diseases/pathology , Gastrointestinal Tract/pathology , Gastrointestinal Diseases/virology , Gastrointestinal Tract/virology , Humans , Pandemics/prevention & control , SARS-CoV-2/pathogenicity
12.
Neurogastroenterol Motil ; 34(2): e14187, 2022 02.
Article in English | MEDLINE | ID: covidwho-1388363

ABSTRACT

BACKGROUND: Gastrointestinal infections represent a risk factor for functional gastrointestinal and somatoform extraintestinal disorders. We investigated the prevalence and relative risk (RR) of gastrointestinal and somatoform symptoms 5 months after SARS-CoV-2 infection compared with a control cohort. METHODS: One hundred and sixty-four SARS-CoV-2 infected patients and 183 controls responded to an online questionnaire about symptoms and signs during the acute phase of the infection and after 4.8 ± 0.3 months. Presence and severity of gastrointestinal symptoms, somatization, anxiety, and depression were recorded with standardized questionnaires. Stool form and presence of irritable bowel syndrome (IBS) were also recorded. Any association between exposure to infection and symptoms was evaluated by calculating crude and adjusted RR values and score differences with 95% confidence intervals (CI). KEY RESULTS: Fever, dyspnea, loss of smell/taste/weight, diarrhea, myalgia, arthralgia, and asthenia were reported by more than 40% of patients during the acute phase. Compared with controls, adjusted RRs for loose stools, chronic fatigue, and somatization were increased after infection: 1.88 (95% CI 0.99-3.54), 2.24 (95% CI 1.48-3.37), and 3.62 (95% CI 1.01-6.23), respectively. Gastrointestinal sequelae were greater in patients with diarrhea during the acute phase. CONCLUSIONS & INFERENCES: Mild gastroenterological symptoms persist 5 months after SARS-CoV-2 infection, in particular in patients reporting diarrhea in the acute phase. Infected patients are at increased risk of chronic fatigue and somatoform disorders, thus supporting the hypothesis that both functional gastrointestinal and somatoform disorders may have a common biological origin.


Subject(s)
COVID-19/complications , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/virology , Somatoform Disorders/epidemiology , Somatoform Disorders/virology , Adult , COVID-19/epidemiology , Cohort Studies , Female , Humans , Italy/epidemiology , Male , Middle Aged , Prevalence , SARS-CoV-2 , Surveys and Questionnaires
14.
Gastroenterology ; 161(6): 2047-2050.e3, 2021 12.
Article in English | MEDLINE | ID: covidwho-1364614

ABSTRACT

One year into the coronavirus disease 2019 (COVID-19) pandemic, the African continent still seems to be spared from the devastating effects the disease had in other continents. Africa's COVID-19 seems to be of a milder nature both in adults and children. However, lack of data from Africa is significant, and more studies are needed to validate the disease status, clinical manifestations, and future implications for Africa. In this study, we report pediatric COVID-19 features in Africa represented by 8 countries.


Subject(s)
COVID-19/epidemiology , Child Health/statistics & numerical data , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/virology , SARS-CoV-2 , Adolescent , Africa/epidemiology , COVID-19/complications , COVID-19/pathology , Child , Child, Preschool , Female , Humans , Infant , Male , Young Adult
15.
Clin Otolaryngol ; 46(6): 1331-1338, 2021 11.
Article in English | MEDLINE | ID: covidwho-1345940

ABSTRACT

OBJECTIVES: This study investigated the relationship between viral load and the incidence of olfactory and gustatory dysfunction (OD and GD), the incidence of respiratory and gastrointestinal symptoms and the recovery of OD and GD in COVID-19 patients. DESIGN: A retrospective cohort study. SETTING AND PARTICIPANTS: This study was conducted on 599 outpatients' cases in Golestan province between February and June 2020. MAIN OUTCOME MEASURES: The incidence, severity (complete or partial) and recovery time of OD and GD and their associations with cycle threshold (CT) values of SARS-CoV-2 polymerase chain reaction were assessed. RESULTS: The mean age of patients was 38.27 ± 13.62 years. The incidence of general symptoms included myalgia 70.1%, headache 51.8%, fever 47.7% and dyspnoea 21.4%. 41.9% of patients had gastrointestinal symptoms, including abdominal pain 26.5%, diarrhoea 25.2%, nausea 20.5% and vomiting 12.9%. 12.2% of patients had comorbidity. The trimester recovery rates of OD and GD were 93.94% and 94.74% respectively. The mean recovery time of OD and GD was 14.56 ± 13.37 and 13.8 ± 3.77 days respectively. The mean CT value in all patients was 27.45 ± 4.55. There were significant associations between the mean of CT value with headache (p = 0.04), GD (p = 0.002) and OD (p = 0.001). CONCLUSIONS: The finding of this study indicates a possible association between viral load with incidence of OD and GD in COVID-19 patient's cases and assures the recovery of OD/GD in these patients.


Subject(s)
COVID-19/complications , Gastrointestinal Diseases/epidemiology , Olfaction Disorders/epidemiology , Respiratory Tract Diseases/epidemiology , Taste Disorders/epidemiology , Viral Load , Adult , Female , Gastrointestinal Diseases/virology , Humans , Incidence , Iran/epidemiology , Male , Olfaction Disorders/virology , Respiratory Tract Diseases/virology , Retrospective Studies , SARS-CoV-2 , Taste Disorders/virology
16.
World J Gastroenterol ; 27(26): 4160-4171, 2021 Jul 14.
Article in English | MEDLINE | ID: covidwho-1319757

ABSTRACT

The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) that causes coronavirus disease-2019 (COVID-19) has provoked a global pandemic, mainly affecting the respiratory tract; however, a percentage of infected individuals can develop gastrointestinal (GI) symptoms. Some studies describe the development of GI symptoms and how they affect the progression of COVID-19. In this review, we summarize the main mechanisms associated with gut damage during infection by SARS-CoV-2 as well as other organs such as the liver and pancreas. Not only are host factors associated with severe COVID-19 but intestinal microbiota dysbiosis is also observed in patients with severe disease.


Subject(s)
COVID-19 , Gastrointestinal Diseases , Gastrointestinal Microbiome , COVID-19/complications , Dysbiosis , Gastrointestinal Diseases/virology , Gastrointestinal Tract , Humans , Inflammation/virology
17.
World J Gastroenterol ; 27(26): 4143-4159, 2021 Jul 14.
Article in English | MEDLINE | ID: covidwho-1319756

ABSTRACT

Coronavirus disease 2019 (COVID-19) can be considered a systemic disease with a specific tropism for the vascular system, in which the alterations of the microcirculation have an important pathogenetic role. The lungs are the main organ involved in COVID-19, and severe progressive respiratory failure is the leading cause of death in the affected patients; however, many other organs can be involved with variable clinical manifestations. Concerning abdominal manifestations, the gastrointestinal tract and the hepatobiliary system are mainly affected, although the pancreas, urinary tract and spleen may also be involved. The most common gastrointestinal symptoms are loss of appetite, followed by nausea and vomiting, diarrhea and abdominal pain. Gastrointestinal imaging findings include bowel wall thickening, sometimes associated with hyperemia and mesenteric thickening, fluid-filled segments of the large bowel and rarely intestinal pneumatosis and ischemia. Hepatic involvement manifests as an increase in the enzymatic levels of alanine aminotransferase, aspartate aminotransferase, serum bilirubin and γ-glutamyl transferase with clinical manifestations in most cases mild and transient. The most frequent radiological features are hepatic steatosis, biliary sludge and gallstones. Edematous acute pancreatitis, kidney infarct and acute kidney injury from acute tubular necrosis have been described more rarely in COVID-19. Lastly, splenic involvement is characterized by splenomegaly and by the development of solitary or multifocal splenic infarcts with classic wedge-shaped or even rounded morphology, with irregular or smooth profiles. In summary, the abdominal radiological findings of COVID-19 are nonspecific and with poor pathological correlation reported in the literature. Ultrasound and particularly computed tomography with multiphasic acquisition are the diagnostic methods mainly utilized in COVID-19 patients with abdominal clinical symptoms and signs. Although radiological signs are not specific of abdominal and gastrointestinal involvement, the diagnostic imaging modalities and in particular computed tomography are helpful for the clinician in the management, evaluation of the severity and evolution of the COVID-19 patients.


Subject(s)
COVID-19 , Gastrointestinal Diseases , Pancreatitis , Acute Disease , COVID-19/complications , Gastrointestinal Diseases/diagnostic imaging , Gastrointestinal Diseases/virology , Gastrointestinal Tract , Humans , Pancreatitis/diagnostic imaging , Pancreatitis/virology , Tomography, X-Ray Computed
18.
J Gastroenterol Hepatol ; 36(3): 694-699, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1301516

ABSTRACT

BACKGROUND AND AIM: Patients with 2019 novel coronavirus disease (COVID-19) could present with gastrointestinal symptoms without fever or respiratory manifestations, which could be overlooked by health-care providers. We aimed to evaluate the clinical characteristics of COVID-19 in patients presenting with initial gastrointestinal symptoms. METHODS: We evaluated all confirmed cases of COVID-19 in Zhongnan Hospital of Wuhan University between January 10 and February 29, 2020. We divided these patients into two groups: patients with initial gastrointestinal symptoms (group A, n = 183) and patients with respiratory syndrome and/or fever (group B, n = 1228). The clinical characteristics, radiological features, and laboratory data were assessed. RESULTS: The clinical procedures of both groups underwent 1-2 weeks rising period and were downward trend at 3 weeks; less than 5% of patients progressed to critical illness. In both groups, mean leukocyte count (P = 0.354) and lymphocyte count (P = 0.386) were below normal, and C-reactive protein level was elevated (P = 0.412). There was mild liver function injury (aspartate aminotransferase, 65.8 ± 12.7 vs 67.4 ± 9.3 U/L, P = 0.246; alanine aminotransferase, 66.4 ± 13.2 vs 69.6 ± 12.7 U/L, P = 0.352), and normal renal function was intact (blood urea nitrogen 6.4 ± 2.5 vs 5.6 ± 2.8 mmol/L P = 0.358; creatinine 85.7 ± 37.2, 91.2 ± 32.6 µmol/L, P = 0.297). After a series of treatment, 176 and 1169 were stable and alive in groups A and B, respectively. The survival rate did not differ significantly between the groups (P = 0.313). CONCLUSION: COVID-19 patients presented with initial gastrointestinal symptoms had similar clinical characteristics and outcomes, when compared with patients with fever and respiratory symptoms.


Subject(s)
COVID-19 Testing/methods , COVID-19/diagnosis , Gastrointestinal Diseases/virology , Adult , Aged , COVID-19/complications , COVID-19/mortality , Case-Control Studies , China/epidemiology , Female , Gastrointestinal Diseases/epidemiology , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Severity of Illness Index , Survival Analysis
19.
Arab J Gastroenterol ; 22(2): 75-87, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1267560

ABSTRACT

In March 2020, the World Health Organization declared coronavirus disease (COVID-19) a pandemic. As of February 2021, there were 107 million COVID-19 cases worldwide. As a comparison, there are approximately 38 million people living with human immunodeficiency virus (PLHIV) worldwide. The coexistence of both epidemics, and the syndemic effect of both viruses could lead to a delirious impact both at individual and community levels. Many intersecting points were found between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19, and HIV; among which, gastrointestinal (GI) manifestations are the most notable. GI manifestations represent a common clinical presentation in both HIV and SARS-CoV-2. The emergence of GI symptoms as a result of SARS-CoV-2 infection provides a new dynamic to COVID-19 diagnosis, management, and infection control measures, and adds an additional diagnostic challenge in case of coinfection with HIV. The presence of GI manifestations in PLHIV during the COVID-19 pandemic could be referred to HIV enteropathy, presence of opportunistic infection, adverse effect of antiretrovirals, or coinfection with COVID-19. Thus, it is important to exclude SARS-CoV-2 in patients who present with new-onset GI manifestations, especially in PLHIV, to avoid the risk of disease transmission during endoscopic interventions. Structural similarities between both viruses adds a valuable intersecting point, which has mutual benefits in the management of both viruses. These similarities led to the hypothesis that antiretrovirals such as lopinavir/Rironavir have a role in the management of COVID-19, which was the target of our search strategy using the available evidence. These similarities may also facilitate the development of an efficient HIV vaccine in the future using the advances in COVID-19 vaccine development.


Subject(s)
COVID-19 , Gastrointestinal Diseases/virology , HIV Infections , COVID-19/complications , HIV Infections/complications , Humans , Pandemics , Syndemic
20.
BMC Infect Dis ; 21(1): 555, 2021 Jun 11.
Article in English | MEDLINE | ID: covidwho-1266474

ABSTRACT

BACKGROUND: Covid-19 in Mexico is on the rise in different parts of the country. We aimed to study the symptoms and comorbidities that associate with this pandemic in 3 different regions of Mexico. METHODS: We analyzed data from SARS-CoV-2 positive patients evaluated at healthcare centers and hospitals of Mexico (n = 1607) including Northwest Mexico (Sinaloa state), Southeast Mexico (Veracruz state) and West Mexico (Jalisco state) between March 1 and July 30, 2020. Mexico consists of a total population that exceeds 128 million. Demographics, comorbidities and clinical symptoms were collected. Statistical descriptive analysis and correlation analyses of symptoms, comorbidities and mortality were performed. RESULTS: A total of 1607 hospitalized patients positive for COVID-19 across all 3 regions of Mexico were included. The average age was 54.6 years and 60.4% were male. A mortality rate of 33.1% was observed. The most common comorbidities were hypertension (43.2%), obesity (30.3%) and diabetes (31.4%). Hypertension was more frequent in West (45%), followed by Northwest (37%) and Southeast Mexico (29%). Obesity was around 30% in Northwest and West whereas an 18% was reported in Southeast. Diabetes was most common in West (34%) followed by Northwest (22%) and Southeast (13%). This might be related to the highest mortality rate in Northwest (31%) and West (37%) when compared to Southeast. Most common symptoms in our overall cohort were fever (80.8%), cough (79.8%), headache (66%), dyspnea (71.1%), myalgia (53.8%), joints pain (50.8%) and odynophagia (34.8%). Diarrhea was the main gastrointestinal (GI) symptom (21.3%), followed by abdominal pain (18%), and nausea/ vomiting (4.5%). Diarrhea and abdominal pain were more common in West (23.1 and 21%), followed by Southeast (17.8, and 9.8%) and Northwest (11.4 and 3.1%). CONCLUSION: Our study showed a high mortality rate likely related to high frequencies of comorbidities (hypertension, obesity and diabetes). Mortality was different across regions. These discrepancies might be related to the differences in the frequencies of comorbidities, and partially attributed to differences in socio-economic conditions and quality of care. Thus, our findings stress the need for improved strategies to get better outcomes in our population.


Subject(s)
COVID-19 , Gastrointestinal Diseases , COVID-19/complications , COVID-19/epidemiology , COVID-19/mortality , Comorbidity , Diabetes Mellitus , Female , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/virology , Humans , Hypertension , Male , Mexico , Middle Aged , Obesity , SARS-CoV-2
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