THE PREVALENCE OF GASTROINTESTINAL SYMPTOMS IN ACUTE COVID-19 INFECTION EVALUATED WITH A DIGITAL QUESTIONNAIRE

ABSTRACT

Introduction: COVID-19 has had a major impact on public health during the last two years. Classic symptoms like fever, cough, and loss of smell and taste are well known. Gastrointestinal symptoms, however, are often not questioned and therefore potentially underestimated. Aim: The aim of this study was to evaluate the prevalence of gastrointestinal symptoms during COVID-19 infection. Methods: A digital questionnaire was used to evaluate symptoms in patients suffering from COVID-19 infection. It was distributed via a patient centered informative website, COVID testing facilities, and the University of Antwerp. The questionnaire contained questions evaluating characteristics of the infection, treatment, general symptoms, and gastrointestinal symptoms. Results: 489 questionnaires were completed, and 430 participants had a confirmed COVID-19 infection. Only data of confirmed cases was used in further analyses. Most patients (76.5%) were diagnosed with PCR testing (63% nasopharyngeal swab, 12.9% saliva, 0.6% combination of both), 7.2% were diagnosed based on serology in blood, 3.1% anamnestic by their treating physician, and 1.2% with other methods like imaging. Of our population, only 6.1% was hospitalized and 12.5% received antibiotics. Two patients (0.5%) were completely asymptomatic. The most prevalent general symptoms were fatigue (76.5%), headache (62.1%), loss of smell (60.0%), muscle aches (59.5%), loss of taste (56.7%), fever (55.6%), and cough (53.0%). All other symptoms like sore throat, rhinorrhea, chest pain, and dyspnea occurred in less than half of our population. A large number (82.1%) of patients had at least one gastrointestinal symptom. The most prevalent symptoms were diarrhea and anorexia (both 52.1%) followed by abdominal pain (50.5%), nausea (40.7%), and vomiting (14.4%). Conclusion: Individual gastrointestinal symptoms were less prevalent than most general symptoms. However, most patients in our study did have at least one gastrointestinal symptom. This demonstrates the importance of inquiring about gastrointestinal symptoms when seeing COVID-19 patients. A potential bias in our study is the possibility that patients suffering from gastrointestinal complaints were more inclined to participate in this study thereby increasing the prevalence of reported symptoms.