A retrospective study of the clinical characteristics of COVID-19 patients with gastrointestinal symptoms

ABSTRACT

Objective: To investigate the gastrointestinal (GI) manifestations of COVID-19 and retrospectively analyze the clinical characteristics of COVID-19 patients with GI symptoms. Methods: Data of 137 COVID-19 inpatients treated in Renmin Hospital of Wuhan University from February 1 to February 29, 2020 were collected. Patients were divided into GI group and Non-GI group according to the presence of digestive system abnormalities and gastrointestinal symptoms before and during admission. General data, clinical data, and relevant laboratory examination results of 137 patients were collected. SPSS 23.0 software was used for statistical analysis to compare the differences of various indicators between the two groups. Results: There was no statistically significant difference between the clinical data and the clinical manifestations of fever and dry cough between the GI group and the Non-GI group (P>0.05). The proportion of patients with fatigue in the GI group was higher than that in the Non-GI group (P<0.001). The proportion of critically ill patients was greater than that of the Non-GI group (P=0.011), and the proportion of GI combined with hypertension, diabetes, cardiovascular disease and chronic liver disease was higher than that of the Non-GI group (all P<0.05). GI group mortality rate was much higher than that of Non-GI group (P<0.001). Patients with GI group had higher white blood cell count and neutrophil count than Non-GI (P<0.001). The proportion of neutrophils, lymphocytes as well as lymph between the two groups had no statistical difference (P>0.05). The proportion of monocytes in the GI group was lower than that in the Non-GI group (P=0.033). There was no statistical difference in platelet count and C-reactive protein level between the two groups (P>0.05). LDH, TBIL, and Urea levels of GI group were higher than those of Non-GI group (P<0.05). There was no statistical difference in other cardiac, liver and kidney function tests, PT and APTT values between the two groups (P>0.05), but D-dimer in GI group was higher than in Non-GI group (P<0.001). Conclusion: Gastrointestinal symptoms are common in COVID-19 patients, and patients with other underlying diseases are at greater risk for developing gastrointestinal symptoms. COVID-19 patients with gastrointestinal symptoms progress more rapidly, have a higher mortality rate, and exhibit certain concomitant symptoms and laboratory tests that are specific to COVID-19. Therefore, more attention should be paid to the digestive system abnormalities and gastrointestinal symptoms in COVID-19 patients during clinical work. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.