1. Digestive Manifestations in Patients Hospitalized with COVID-19
- Author
-
Vikesh K. Singh, Ashwinee Condon, Rosemary Nustas, Judy A. Trieu, Robin B. Mendelsohn, Don C. Rockey, Joy M. Hutchinson, Nauzer Forbes, Lujain Jaza, Eric F. Howard, Christopher S. Huang, Sheryl J. Korsnes, Delia Calo, Gabriela Kuftinec, Rebecca L. Spitzer, Vikram Kanagala, Maria Ines Pinto-Sanchez, Georgios I. Papachristou, Mary K. West, Andrew M. Aneese, Janak N. Shah, Stephanie Mitchell, Jennifer M. Kolb, Benita K. Glamour, Selena Zhou, Luis F. Lara, Gail McNulty, Kulwinder S. Dua, Jordan Wood, Duyen T. Dang, Jason R. Taylor, Ayesha Kamal, William M. Tierney, Harminder Singh, Jeong Yun Yang, Liam Hilson, Cyrus R. Piraka, Sunil Amin, Rebekah E. Dixon, B. Joseph Elmunzer, Vladimir Kushnir, Teldon B. Alford, Millie Chau, Richard S. Kwon, Abdul Haseeb, Emil Agarunov, Lydia D. Foster, Evan L. Fogel, Caroline G. McLeod, Charlie Fox, Laith H. Jamil, Olga C. Aroniadis, Joseph F. LaComb, Emad Qayed, Eric D. Shah, Harsh K. Patel, Ambreen A. Merchant, Michael L. Volk, Ali Zakaria, Valerie Durkalski, Amrita Sethi, Adrienne Lenhart, Swati Pawa, Rishi Pawa, Amar R. Deshpande, Marc S. Piper, Alexandria M. Lenyo, Bryan G. Sauer, Zahra Solati, James M. Scheiman, Dhiraj Yadav, Andrew Canakis, Heiko Pohl, Zachary L. Smith, Vaishali Patel, and Katherine A. Hanley
- Subjects
Mechanical ventilation ,medicine.medical_specialty ,Abdominal pain ,business.industry ,Nausea ,medicine.medical_treatment ,Confounding ,Odds ratio ,Confidence interval ,Diarrhea ,Internal medicine ,medicine ,Vomiting ,medicine.symptom ,business - Abstract
BackgroundThe prevalence and significance of digestive manifestations in COVID-19 remain uncertain.MethodsConsecutive 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 manually abstracted 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.ResultsA total of 1992 patients across 36 centers met eligibility criteria and were included. Overall, 53% of patients experienced at least one 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 elevated 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% confidence interval 0.76-1.15) or liver test abnormalities on admission (odds ratio 1.31, 95% confidence interval 0.80-2.12) were not independently associated with mechanical ventilation or death.ConclusionsAmong 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
- Published
- 2020