tetano
Editor, Senior Moderator
Gastro Hep Adv
. 2022 Jul 19.
doi: 10.1016/j.gastha.2022.07.002. Online ahead of print.
Gastrointestinal Manifestations of Coronavirus Disease 2019 across the United States: A Multi-Center Cohort Study
Ankur P Patel[SUP] 1 2 [/SUP], Troy K Sanders[SUP] 1 [/SUP], Preeti Prakash[SUP] 1 [/SUP], Jade Law[SUP] 3 [/SUP], Sujay Alvencar[SUP] 4 [/SUP], Alyssa Choi[SUP] 5 [/SUP], Janaki Shah[SUP] 6 [/SUP], Karishma Patel[SUP] 7 [/SUP], Padmavathi Srivoleti[SUP] 8 [/SUP], Kirtan Chauhan[SUP] 2 9 [/SUP], Simcha Weissman[SUP] 10 [/SUP], Erik Holzwanger[SUP] 4 [/SUP], Rohit Dhingra[SUP] 4 [/SUP], Michelle Nguyen[SUP] 4 [/SUP], Daniel Kim[SUP] 5 [/SUP], Tahnee Sidhu[SUP] 8 [/SUP], Christopher Stallwood[SUP] 8 [/SUP], Aaron Dickstein[SUP] 4 [/SUP], Nimisha Parekh[SUP] 5 [/SUP], Osama Altayar[SUP] 6 [/SUP], Matthew A Ciorba[SUP] 6 [/SUP], Jessica Yu[SUP] 7 [/SUP], Lea Ann Chen[SUP] 11 [/SUP], James H Tabibian[SUP] 1 3 [/SUP], Berkeley N Limketkai[SUP] 1 12 [/SUP]
Affiliations
Abstract
Backgroun and aims: Gastrointestinal (GI) symptoms occur among patients diagnosed with coronavirus disease 2019 (COVID-19), and there is clear evidence that SARS-CoV-2, the causative pathogen, infects the GI tract. In this large, multi-center cohort study, we evaluated variations in gastrointestinal (GI) and hepatic manifestations of COVID-19 throughout the United States (US).
Methods: Patients hospitalized with a positive COVID-19 test prior to October 2020 were identified at seven US academic centers. Demographics, presenting symptoms, laboratory data, and hospitalization outcomes were abstracted. Descriptive and regression analyses were used to evaluate GI manifestations and their potential predictors.
Results: Among 2,031 hospitalized patients with COVID-19, GI symptoms were present in 18.9%; diarrhea was the most common (15.2%), followed by nausea and/or vomiting (12.6%) and abdominal pain (6.0%). GI symptoms were less common in the Western cohort (16.0%) than the Northeastern (25.6%) and Midwestern (26.7%) cohorts. Compared to non-ICU patients, ICU patients had a higher prevalence of abnormal aspartate aminotransferase (AST) (58.1% vs. 37.3%; p<0.01), alanine aminotransferase (ALT) (37.5% vs. 29.3%; p=0.01), and total bilirubin (12.7% vs. 9.0%; p<0.01). ICU patients also had a higher mortality rate (22.7% vs. 4.7%; p<0.01). Chronic liver disease was associated with the development of GI symptoms. Abnormal AST or ALT were associated with an increased risk of ICU admission.
Conclusion: We present the largest multi-center cohort of patients with COVID-19 across the US. GI manifestations were common among patients hospitalized with COVID-19, although there was significant variability in prevalence and predictors across the US.
Keywords: AIDS, acquired immunodeficiency syndrome; ALT, alanine aminotransferase; ANOVA, analysis of variance; AST, aspartate aminotransferase; BMI, body mass index; CI, confidence interval; COVID-19; COVID-19, coronavirus disease 2019; Coronavirus disease 2019; GI, gastrointestinal; HIV, human immunodeficiency virus; ICU, intensive care unit; IRB, Institutional Review Board; OR, odds ratio; SARS-CoV-2; SD, standard deviation; UCLA, University of California Los Angeles; US, United States; WHO, World Health Organization; aOR, adjusted odds ratio; gastrointestinal.
. 2022 Jul 19.
doi: 10.1016/j.gastha.2022.07.002. Online ahead of print.
Gastrointestinal Manifestations of Coronavirus Disease 2019 across the United States: A Multi-Center Cohort Study
Ankur P Patel[SUP] 1 2 [/SUP], Troy K Sanders[SUP] 1 [/SUP], Preeti Prakash[SUP] 1 [/SUP], Jade Law[SUP] 3 [/SUP], Sujay Alvencar[SUP] 4 [/SUP], Alyssa Choi[SUP] 5 [/SUP], Janaki Shah[SUP] 6 [/SUP], Karishma Patel[SUP] 7 [/SUP], Padmavathi Srivoleti[SUP] 8 [/SUP], Kirtan Chauhan[SUP] 2 9 [/SUP], Simcha Weissman[SUP] 10 [/SUP], Erik Holzwanger[SUP] 4 [/SUP], Rohit Dhingra[SUP] 4 [/SUP], Michelle Nguyen[SUP] 4 [/SUP], Daniel Kim[SUP] 5 [/SUP], Tahnee Sidhu[SUP] 8 [/SUP], Christopher Stallwood[SUP] 8 [/SUP], Aaron Dickstein[SUP] 4 [/SUP], Nimisha Parekh[SUP] 5 [/SUP], Osama Altayar[SUP] 6 [/SUP], Matthew A Ciorba[SUP] 6 [/SUP], Jessica Yu[SUP] 7 [/SUP], Lea Ann Chen[SUP] 11 [/SUP], James H Tabibian[SUP] 1 3 [/SUP], Berkeley N Limketkai[SUP] 1 12 [/SUP]
Affiliations
- PMID: 35874930
- PMCID: PMC9293374
- DOI: 10.1016/j.gastha.2022.07.002
Abstract
Backgroun and aims: Gastrointestinal (GI) symptoms occur among patients diagnosed with coronavirus disease 2019 (COVID-19), and there is clear evidence that SARS-CoV-2, the causative pathogen, infects the GI tract. In this large, multi-center cohort study, we evaluated variations in gastrointestinal (GI) and hepatic manifestations of COVID-19 throughout the United States (US).
Methods: Patients hospitalized with a positive COVID-19 test prior to October 2020 were identified at seven US academic centers. Demographics, presenting symptoms, laboratory data, and hospitalization outcomes were abstracted. Descriptive and regression analyses were used to evaluate GI manifestations and their potential predictors.
Results: Among 2,031 hospitalized patients with COVID-19, GI symptoms were present in 18.9%; diarrhea was the most common (15.2%), followed by nausea and/or vomiting (12.6%) and abdominal pain (6.0%). GI symptoms were less common in the Western cohort (16.0%) than the Northeastern (25.6%) and Midwestern (26.7%) cohorts. Compared to non-ICU patients, ICU patients had a higher prevalence of abnormal aspartate aminotransferase (AST) (58.1% vs. 37.3%; p<0.01), alanine aminotransferase (ALT) (37.5% vs. 29.3%; p=0.01), and total bilirubin (12.7% vs. 9.0%; p<0.01). ICU patients also had a higher mortality rate (22.7% vs. 4.7%; p<0.01). Chronic liver disease was associated with the development of GI symptoms. Abnormal AST or ALT were associated with an increased risk of ICU admission.
Conclusion: We present the largest multi-center cohort of patients with COVID-19 across the US. GI manifestations were common among patients hospitalized with COVID-19, although there was significant variability in prevalence and predictors across the US.
Keywords: AIDS, acquired immunodeficiency syndrome; ALT, alanine aminotransferase; ANOVA, analysis of variance; AST, aspartate aminotransferase; BMI, body mass index; CI, confidence interval; COVID-19; COVID-19, coronavirus disease 2019; Coronavirus disease 2019; GI, gastrointestinal; HIV, human immunodeficiency virus; ICU, intensive care unit; IRB, Institutional Review Board; OR, odds ratio; SARS-CoV-2; SD, standard deviation; UCLA, University of California Los Angeles; US, United States; WHO, World Health Organization; aOR, adjusted odds ratio; gastrointestinal.