Digestive manifestations in patients hospitalized with Coronavirus disease 2019 Journal Article


Authors: Elmunzer, B. J.; Spitzer, R. L.; Foster, L. D.; Merchant, A. A.; Howard, E. F.; Patel, V. A.; West, M. K.; Qayed, E.; Nustas, R.; Zakaria, A.; Piper, M. S.; Taylor, J. R.; Jaza, L.; Forbes, N.; Chau, M.; Lara, L. F.; Papachristou, G. I.; Volk, M. L.; Hilson, L. G.; Zhou, S.; Kushnir, V. M.; Lenyo, A. M.; McLeod, C. G.; Amin, S.; Kuftinec, G. N.; Yadav, D.; Fox, C.; Kolb, J. M.; Pawa, S.; Pawa, R.; Canakis, A.; Huang, C.; Jamil, L. H.; Aneese, A. M.; Glamour, B. K.; Smith, Z. L.; Hanley, K. A.; Wood, J.; Patel, H. K.; Shah, J. N.; Agarunov, E.; Sethi, A.; Fogel, E. L.; McNulty, G.; Haseeb, A.; Trieu, J. A.; Dixon, R. E.; Yang, J. Y.; Mendelsohn, R. B.; Calo, D.; Aroniadis, O. C.; LaComb, J. F.; Scheiman, J. M.; Sauer, B. G.; Dang, D. T.; Piraka, C. R.; Shah, E. D.; Pohl, H.; Tierney, W. M.; Mitchell, S.; Condon, A.; Lenhart, A.; Dua, K. S.; Kanagala, V. S.; Kamal, A.; Singh, V. K.; Pinto-Sanchez, M. I.; Hutchinson, J. M.; Kwon, R. S.; Korsnes, S. J.; Singh, H.; Solati, Z.; Willingham, F. F.; Yachimski, P. S.; Conwell, D. L.; Mosier, E.; Azab, M.; Patel, A.; Buxbaum, J.; Wani, S.; Chak, A.; Hosmer, A. E.; Keswani, R. N.; DiMaio, C. J.; Bronze, M. S.; Muthusamy, R.; Canto, M. I.; Gjeorgjievski, V. M.; Imam, Z.; Odish, F.; Edhi, A. I.; Orosey, M.; Tiwari, A.; Patwardhan, S.; Brown, N. G.; Patel, A. A.; Ordiah, C. O.; Sloan, I. P.; Cruz, L.; Koza, C. L.; Okafor, U.; Hollander, T.; Furey, N.; Reykhart, O.; Zbib, N. H.; Damianos, J. A.; Esteban, J.; Hajidiacos, N.; Saul, M.; Mays, M.; Anderson, G.; Wood, K.; Mathews, L.; Diakova, G.; Caisse, M.; Wakefield, L.; Nitchie, H.; Waljee, A. K.; Tang, W.; Zhang, Y.; Zhu, J.; Deshpande, A. R.; Rockey, D. C.; Alford, T. B.; Durkalski, V.; for the North AmericanAlliance for the Study of Digestive Manifestations of COVID-19
Article Title: Digestive manifestations in patients hospitalized with Coronavirus disease 2019
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. © 2021 AGA Institute
Keywords: gastrointestinal symptoms; covid-19; sars-cov-2; digestive manifestations; hepatic manifestations
Journal Title: Clinical Gastroenterology and Hepatology
Volume: 19
Issue: 7
ISSN: 1542-3565
Publisher: Elsevier Science, Inc.  
Date Published: 2021-07-01
Start Page: 1355
End Page: 1365.e4
Language: English
DOI: 10.1016/j.cgh.2020.09.041
PUBMED: 33010411
PROVIDER: scopus
PMCID: PMC7527302
DOI/URL:
Notes: Article -- Export Date: 1 July 2021 -- Source: Scopus
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