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Gastrointestinal Bleeding, but Not Other Gastrointestinal Symptoms, Is Associated With Worse Outcomes in COVID-19 Patients.
Chen, Hongxin; Tong, Zhenhua; Ma, Zhuang; Luo, Li; Tang, Yufu; Teng, Yue; Yu, Hao; Meng, Hao; Peng, Chengfei; Zhang, Quanyu; Zhu, Tianyi; Zhao, Haitao; Chu, Guiyang; Li, Hongyu; Lu, Hui; Qi, Xingshun.
  • Chen H; COVID-19 Study Group, General Hospital of Northern Theater Command, Shenyang, China.
  • Tong Z; Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China.
  • Ma Z; Postgraduate College, Liaoning University of Traditional Chinese Medicine, Shenyang, China.
  • Luo L; COVID-19 Study Group, General Hospital of Northern Theater Command, Shenyang, China.
  • Tang Y; Section of Medical Service, General Hospital of Northern Theater Command, Shenyang, China.
  • Teng Y; COVID-19 Study Group, General Hospital of Northern Theater Command, Shenyang, China.
  • Yu H; Department of Respiratory Medicine, General Hospital of Northern Theater Command, Shenyang, China.
  • Meng H; Department of Infectious Diseases, Wuhan Huoshenshan Hospital, Wuhan, China.
  • Peng C; COVID-19 Study Group, General Hospital of Northern Theater Command, Shenyang, China.
  • Zhang Q; COVID-19 Study Group, General Hospital of Northern Theater Command, Shenyang, China.
  • Zhu T; Department of Infectious Diseases, Wuhan Huoshenshan Hospital, Wuhan, China.
  • Zhao H; COVID-19 Study Group, General Hospital of Northern Theater Command, Shenyang, China.
  • Chu G; Department of Infectious Diseases, Wuhan Huoshenshan Hospital, Wuhan, China.
  • Li H; COVID-19 Study Group, General Hospital of Northern Theater Command, Shenyang, China.
  • Lu H; Department of Infectious Diseases, Wuhan Huoshenshan Hospital, Wuhan, China.
  • Qi X; COVID-19 Study Group, General Hospital of Northern Theater Command, Shenyang, China.
Front Med (Lausanne) ; 8: 759152, 2021.
Article in English | MEDLINE | ID: covidwho-1497097
ABSTRACT

Background:

Patients with coronavirus disease 2019 (COVID-19) can present with gastrointestinal (GI) symptoms. However, the prevalence of GI symptoms and their association with outcomes remain controversial in COVID-19 patients.

Methods:

All COVID-19 patients consecutively admitted to the Wuhan Huoshenshan hospital from February 2020 to April 2020 were collected. Disease severity and outcomes were compared between COVID-19 patients with and without GI symptoms. Logistic regression analyses were performed to evaluate the association of GI symptoms with the composite endpoint and death in COVID-19 patients. A composite endpoint was defined as transfer to intensive care unit, requirement of mechanical ventilation, and death. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.

Results:

Overall, 2,552 COVID-19 patients were included. The prevalence of GI symptoms was 21.0% (537/2,552). Diarrhea (8.9%, 226/2,552) was the most common GI symptom. Patients with GI symptoms had significantly higher proportions of severe COVID-19 and worse outcomes than those without. Univariate logistic regression analyses demonstrated that GI symptoms were significantly associated with the composite endpoint (OR = 2.426, 95% CI = 1.608-3.661; P < 0.001) and death (OR = 2.137, 95% CI = 1.209-3.778; P = 0.009). After adjusting for age, sex, and severe/critical COVID-19, GI symptoms were still independently associated with the composite endpoint (OR = 2.029, 95% CI = 1.294-3.182; P = 0.002), but not death (OR = 1.726, 95% CI = 0.946-3.150; P = 0.075). According to the type of GI symptoms, GI bleeding was an independent predictor of the composite endpoint (OR = 8.416, 95% CI = 3.465-20.438, P < 0.001) and death (OR = 6.640, 95% CI = 2.567-17.179, P < 0.001), but not other GI symptoms (i.e., diarrhea, abdominal discomfort, nausea and/or vomiting, constipation, acid reflux and/or heartburn, or abdominal pain).

Conclusion:

GI symptoms are common in COVID-19 patients and may be associated with their worse outcomes. Notably, such a negative impact of GI symptoms on the outcomes should be attributed to GI bleeding.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article Affiliation country: Fmed.2021.759152

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article Affiliation country: Fmed.2021.759152