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Digestive Manifestations in Patients Hospitalized With Coronavirus Disease 2019.
Elmunzer, B Joseph; Spitzer, Rebecca L; Foster, Lydia D; Merchant, Ambreen A; Howard, Eric F; Patel, Vaishali A; West, Mary K; Qayed, Emad; Nustas, Rosemary; Zakaria, Ali; Piper, Marc S; Taylor, Jason R; Jaza, Lujain; Forbes, Nauzer; Chau, Millie; Lara, Luis F; Papachristou, Georgios I; Volk, Michael L; Hilson, Liam G; Zhou, Selena; Kushnir, Vladimir M; Lenyo, Alexandria M; McLeod, Caroline G; Amin, Sunil; Kuftinec, Gabriela N; Yadav, Dhiraj; Fox, Charlie; Kolb, Jennifer M; Pawa, Swati; Pawa, Rishi; Canakis, Andrew; Huang, Christopher; Jamil, Laith H; Aneese, Andrew M; Glamour, Benita K; Smith, Zachary L; Hanley, Katherine A; Wood, Jordan; Patel, Harsh K; Shah, Janak N; Agarunov, Emil; Sethi, Amrita; Fogel, Evan L; McNulty, Gail; Haseeb, Abdul; Trieu, Judy A; Dixon, Rebekah E; Yang, Jeong Yun; Mendelsohn, Robin B; Calo, Delia.
  • Elmunzer BJ; Division of Gastroenterology and Hepatology, Department of Medicine, Charleston, South Carolina. Electronic address: elmunzer@musc.edu.
  • Spitzer RL; Division of Gastroenterology and Hepatology, Department of Medicine, Charleston, South Carolina.
  • Foster LD; Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina.
  • Merchant AA; Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
  • Howard EF; Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
  • Patel VA; Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
  • West MK; Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
  • Qayed E; Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia; Division of Digestive Diseases, Department of Medicine, Grady Memorial Hospital, Atlanta, Georgia.
  • Nustas R; Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia; Division of Digestive Diseases, Department of Medicine, Grady Memorial Hospital, Atlanta, Georgia.
  • Zakaria A; Division of Gastroenterology, Department of Medicine, Ascension Providence Hospital/Michigan State University, College of Human Medicine, Southfield, Michigan.
  • Piper MS; Division of Gastroenterology, Department of Medicine, Ascension Providence Hospital/Michigan State University, College of Human Medicine, Southfield, Michigan.
  • Taylor JR; Division of Gastroenterology and Hepatology, Department of Medicine, Saint Louis University, St. Louis, Missouri.
  • Jaza L; Division of Gastroenterology and Hepatology, Department of Medicine, Saint Louis University, St. Louis, Missouri.
  • Forbes N; Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Chau M; Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Lara LF; Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
  • Papachristou GI; Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
  • Volk ML; Division of Gastroenterology, Department of Medicine, Loma Linda University, Loma Linda, California.
  • Hilson LG; Division of Gastroenterology, Department of Medicine, University of Southern California, Los Angeles, California.
  • Zhou S; Division of Gastroenterology, Department of Medicine, University of Southern California, Los Angeles, California.
  • Kushnir VM; Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
  • Lenyo AM; Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
  • McLeod CG; Division of Gastroenterology and Hepatology, Department of Medicine, Charleston, South Carolina.
  • Amin S; Division of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida.
  • Kuftinec GN; Division of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida.
  • Yadav D; Division of Gastroenterology and Hepatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
  • Fox C; Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
  • Kolb JM; Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
  • Pawa S; Division of Gastroenterology, Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
  • Pawa R; Division of Gastroenterology, Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
  • Canakis A; Section of Gastroenterology, Department of Medicine, Boston University Medical Center, Boston, Massachusetts.
  • Huang C; Section of Gastroenterology, Department of Medicine, Boston University Medical Center, Boston, Massachusetts.
  • Jamil LH; Section of Gastroenterology and Hepatology, Department of Internal Medicine, Beaumont Health, Royal Oak, Michigan; Oakland University William Beaumont School of Medicine, Rochester, Michigan.
  • Aneese AM; Section of Gastroenterology and Hepatology, Department of Internal Medicine, Beaumont Health, Royal Oak, Michigan.
  • Glamour BK; Division of Gastroenterology, Department of Medicine, University Hospitals of Cleveland Medical Center, Cleveland, Ohio.
  • Smith ZL; Division of Gastroenterology, Department of Medicine, University Hospitals of Cleveland Medical Center, Cleveland, Ohio.
  • Hanley KA; Division of Gastroenterology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
  • Wood J; Division of Gastroenterology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
  • Patel HK; Department of Gastroenterology, Ochsner Health, New Orleans, Louisiana.
  • Shah JN; Department of Gastroenterology, Ochsner Health, New Orleans, Louisiana.
  • Agarunov E; Division of Gastroenterology, Department of Medicine, Columbia University Medical Center, New York, New York.
  • Sethi A; Division of Gastroenterology, Department of Medicine, Columbia University Medical Center, New York, New York.
  • Fogel EL; Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
  • McNulty G; Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
  • Haseeb A; Division of Gastroenterology and Nutrition, Department of Medicine, Loyola University Medical Center, Chicago, Illinois.
  • Trieu JA; Division of Gastroenterology and Nutrition, Department of Medicine, Loyola University Medical Center, Chicago, Illinois.
  • Dixon RE; The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
  • Yang JY; The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
  • Mendelsohn RB; Gastroenterology, Hepatology and Nutrition service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Calo D; Gastroenterology, Hepatology and Nutrition service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Clin Gastroenterol Hepatol ; 19(7): 1355-1365.e4, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1071144
ABSTRACT
BACKGROUND &

AIMS:

The prevalence and significance of digestive manifestations in coronavirus disease 2019 (COVID-19) remain uncertain. We aimed to assess the prevalence, spectrum, severity, and significance of digestive manifestations in patients hospitalized with COVID-19.

METHODS:

Consecutive patients hospitalized with COVID-19 were identified across a geographically diverse alliance of medical centers in North America. Data pertaining to baseline characteristics, symptomatology, laboratory assessment, imaging, and endoscopic findings from the time of symptom onset until discharge or death were abstracted manually from electronic health records to characterize the prevalence, spectrum, and severity of digestive manifestations. Regression analyses were performed to evaluate the association between digestive manifestations and severe outcomes related to COVID-19.

RESULTS:

A total of 1992 patients across 36 centers met eligibility criteria and were included. Overall, 53% of patients experienced at least 1 gastrointestinal symptom at any time during their illness, most commonly diarrhea (34%), nausea (27%), vomiting (16%), and abdominal pain (11%). In 74% of cases, gastrointestinal symptoms were judged to be mild. In total, 35% of patients developed an abnormal alanine aminotransferase or total bilirubin level; these were increased to less than 5 times the upper limit of normal in 77% of cases. After adjusting for potential confounders, the presence of gastrointestinal symptoms at any time (odds ratio, 0.93; 95% CI, 0.76-1.15) or liver test abnormalities on admission (odds ratio, 1.31; 95% CI, 0.80-2.12) were not associated independently with mechanical ventilation or death.

CONCLUSIONS:

Among patients hospitalized with COVID-19, gastrointestinal symptoms and liver test abnormalities were common, but the majority were mild and their presence was not associated with a more severe clinical course.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Gastrointestinal Diseases / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: North America Language: English Journal: Clin Gastroenterol Hepatol Journal subject: Gastroenterology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Gastrointestinal Diseases / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: North America Language: English Journal: Clin Gastroenterol Hepatol Journal subject: Gastroenterology Year: 2021 Document Type: Article