Early viral versus late antibiotic-associated diarrhea in novel coronavirus infection.
Medicine (Baltimore)
; 100(41): e27528, 2021 Oct 15.
Article
in English
| MEDLINE | ID: covidwho-1501205
ABSTRACT
ABSTRACT Diarrhea is one of the manifestations of the novel coronavirus disease (COVID-19), but it also develops as a complication of massive antibiotic therapy in this disease. This study aimed to compare these types of diarrhea.We included patients with COVID-19 in a cohort study and excluded patients with chronic diarrhea, laxative use, and those who died during the first day of hospitalization.There were 89 (9.3%), 161 (16.7%), and 731 (75.7%) patients with early viral, late antibiotic-associated, and without diarrhea, respectively. Late diarrhea lasted longer (6 [4-10] vs 5 [3-7] days, Pâ<â.001) and was more severe. Clostridioides difficile was found in 70.5% of tested patients with late diarrhea and in none with early diarrhea. Presence of late diarrhea was associated with an increased risk of death after 20âdays of disease (Pâ=â.009; hazard ratioâ=â4.7). Patients with late diarrhea had a longer hospital stay and total disease duration, and a higher proportion of these patients required intensive care unit admission. Oral amoxicillin/clavulanate (odds ratio [OR]â=â2.23), oral clarithromycin (ORâ=â3.79), and glucocorticoids (ORâ=â4.41) use was a risk factor for the development of late diarrhea, while ceftriaxone use (ORâ=â0.35) had a protective effect. Before the development of late diarrhea, decrease in C-reactive protein levels and increase in lymphocyte count stopped but the white blood cell and neutrophil count increased. An increase in neutrophils by >0.6â×â109âcells/L predicted the development of late diarrhea in the coming days (sensitivity 82.0%, specificity 70.8%, area under the curveâ=â0.791 [0.710-0.872]).Diarrhea in COVID-19 is heterogeneous, and different types of diarrhea require different management.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Diarrhea
/
COVID-19
/
Anti-Bacterial Agents
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Aged
/
Humans
/
Middle aged
Language:
English
Journal:
Medicine (Baltimore)
Year:
2021
Document Type:
Article
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