Hepatic and gastrointestinal manifestations of SARS-COV-2 infection (COVID-19)

ABSTRACT

Background and aim: Abnormal liver function tests (LFTs) and gastrointestinal (GI) symptoms have been reported up to 50% in patients with COVID-19, and in 5% they can precede respiratory symptoms. The objective of this work is to describe the LFTs and GI symptoms of patients with COVID-19 and their association with admission to the intensive care unit (ICU) and mortality. Material and Methods. We conducted a retrospective, cross sectional, descriptive study, using files from patients with a positive Gen Finder COVID-19 test, admitted to Medica Sur Clinic and Foundation between March 13th through May 14th, 2020. We performed descriptive analysis of data and its association with clinical outcomes. Results: A total of 108 patients with COVID-19 were identified;68.5% (n = 74) were men, the mean age was 53 ± 14 years and the body mass index was 28.6 ± 5.8 kg/m2. The most frequent comorbidity was hypertension with 24% (n = 26). The presence of comorbidities was associated with risk of ICU admission (OR 3.9 [95% CI 1.6-9.9], p = 0.002). The most frequent symptoms were cough (72.2%, n = 78), fever (69.4%, n = 75) and dyspnea (48.1%, n = 52). At least one abnormal LFT was present in 94% (n = 103) of patients at admission, the most frequent was LDH (88.9%, n = 96), AST and GGT (63%, n = 65), which are summarized in Table 1. Patients presented abnormal LFTs and respiratory symptoms in 48.1% (n = 52), while 16.6% (n = 18) presented abnormal LFTs without respiratory symptoms. Among GI symptoms, 37% (n = 4) reported at least one, including diarrhea (28.7%, n = 31), hyporexia (9.3%, n = 10), nausea (8.3%, n = 9) or vomiting (4.6%, n = 5). Of patients admitted to the ICU (n = 39), 27.5% (n = 10) presented at least one GI symptom. Mortality was 7.4% (n = 8). No associations were found between abnormal LFTs, GI symptoms, and outcomes of mortality and ICU admission. Conclusions: In patients with COVID 19, the presence of metabolic comorbidities confers a higher risk of ICU admission, in contrast to abnormal LFTs and GI symptoms that were not associated with clinical outcomes. Conflicts of interest The authors have no conflicts of interest to declare.