RESUMO
Abdominal pain and liver injury have been frequently reported during coronavirus disease-2019 (COVID-19). Our aim was to investigate characteristics of abdominal pain in COVID-19 patients and their association with disease severity and liver injury.Data of all COVID-19 patients hospitalized during the first wave in one hospital were retrieved. Patients admitted exclusively for other pathologies and/or recovered from COVID-19, as well as pregnant women were excluded. Patients whose abdominal pain was related to alternative diagnosis were also excluded.Among the 1026 included patients, 200 (19.5%) exhibited spontaneous abdominal pain and 165 (16.2%) after abdomen palpation. Spontaneous pain was most frequently localized in the epigastric (42.7%) and right upper quadrant (25.5%) regions. Tenderness in the right upper region was associated with severe COVID-19 (hospital mortality and/or admission to intensive/intermediate care unit) with an adjusted odds ratio of 2.81 (95% CI 1.27-6.21, p = 0.010). Patients with history of lower abdomen pain experimented less frequently dyspnea compared to patients with history of upper abdominal pain (25.8 versus 63.0%, p < 0.001). Baseline transaminases elevation was associated with history of pain in epigastric and right upper region and AST elevation was strongly associated with severe COVID-19 with an odds ratio of 16.03 (95% CI 1.95-131.63 p = 0.010).More than one fifth of patients admitted for COVID-19 presented abdominal pain. Those with pain located in the upper abdomen were more at risk of dyspnea, demonstrated more altered transaminases, and presented a higher risk of adverse outcomes.
Assuntos
COVID-19 , Abdome , Dor Abdominal/etiologia , COVID-19/complicações , Dispneia , Feminino , Humanos , Gravidez , Estudos Retrospectivos , SARS-CoV-2 , TransaminasesRESUMO
Cirrhosis results from chronic liver disease and is associated with a high mortality. The most frequent causes for chronic liver disease include alcoholic liver disease, non-alcoholic fatty liver disease and viral hepatitis B and C. Bacterial infections often complicate decompensated cirrhosis. It is estimated that up to 35% of patients with decompensated cirrhosis have an infection at admission or during hospital stay. There are considerable consequences to these bacterial infections. Whilst evidence supports the use of prophylactic antibiotics, the emergence of multi-resistant bacteria is changing the spectrum of antibiotics that have to be used.
La cirrhose, résultat d'une maladie chronique du foie, est grevée d'une mortalité élevée. Les causes les plus fréquentes sont les hépatopathies alcoolique et dysmétabolique ainsi que les hépatites virales B et C. Les infections bactériennes sont une cause fréquente de complication de la décompensation cirrhotique. Il est estimé que 25 à 35â % des patients en décompensation cirrhotique présentent une infection à leur admission ou durant le séjour hospitalier. Les conséquences de l'infection bactérienne chez un patient cirrhotique sont considérables. L'évidence soutient l'utilisation d'une antibiothérapie prophylactique, mais la présence de plus en plus fréquente de germes avec des profils de résistance étendus pousse à recourir aux antibiotiques à spectre large.
