Prevalence of Gastrointestinal Symptoms in COVID-19 Patients; Result From Tertiary Care Hospital in Pakistan
Sažetak
Background/Aim: The most commonly reported COVID-19 symptoms are high-grade fever, cough and body aches with atypical symptoms ie vomiting, diarrhoea and abdominal discomfort. The primary purpose of this research was to ascertain the frequency of gastrointestinal problems experienced by patients due to COVID-19. Goal was to determine whether or not there was a correlation between the severity of COVID-19 disease and the presence of gastrointestinal symptoms in studied individuals.
Methods: The study was conducted at the Gastroenterology Department, PEMH Rawalpindi, Pakistan from January 2022 to January 2023. Confirmed inpatient cases of COVID-19 disease were recruited, referred to Pak Emirates Military Hospital Rawalpindi, Pakistan. Real-time polymerase chain reaction (RT-PCR) verified the presence of COVID-19 in the patients of this research study.
Results: There were 345 patients (335 men and 10 women), with 116 patients exhibiting gastrointestinal symptoms and only 27 patients presented with severe disease. Diarrhoea and anorexia were the most frequently reported digestive symptoms with a frequency of 44 (12.8 %) and 34 (9.9 %), respectively. Clinical outcomes and disease severity were not significantly different between patients with and without digestive issues.
Conclusion: The course of a COVID-19 infection seems to include gastrointestinal symptoms, which include, but are not limited to vomiting, diarrhoea, anorexia, etc. Numerous gastrointestinal symptoms are linked to COVID-19 infection even in the absence of respiratory symptoms. As a result, COVID-19 infection should be taken into account for individuals who primarily present with gastrointestinal symptoms. The establishment of personalised COVID-19 therapies will be aided by an understanding of the varying susceptibility of the individual gastrointestinal system to SARS-CoV-2.
Reference
Vespa E, Pugliese N, Colapietro F, Aghemo A. Stay (GI) Healthy: COVID-19 and Gastrointestinal Manifestations. Tech Innov Gastrointest Endosc. 2021;23(2):179-89. doi: 10.1016/j.tige.2021.01.006.
Wu D, Wu T, Liu Q, Yang Z. The SARS-CoV-2 outbreak: What we know. Int J Infect Dis. 2020 May;94:44-48. doi: 10.1016/j.ijid.2020.03.004.
Yang Y, Xiao Z, Ye K, He X, Sun B, Qin Z, et al. SARS-CoV-2: characteristics and current advances in research. Virol J. 2020;17(1):117. doi: 10.1186/s12985-020-01369-z.
Wark PAB, Pathinayake PS, Kaiko G, Nichol K, Ali A, Chen L, et al. ACE2 expression is elevated in airway epithelial cells from older and male healthy individuals but reduced in asthma. Respirology. 2021;26(5):442-51. doi: 10.1111/resp.14003.
Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology. 2020;158(6):1831-3 e3. doi: 10.1053/j.gastro.2020.02.055.
Lin L, Jiang X, Zhang Z, Huang S, Zhang Z, Fang Z, et al. Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection. Gut. 2020 Jun;69(6):997-1001. doi: 10.1136/gutjnl-2020-321013.
Hajifathalian K, Krisko T, Mehta A, Kumar S, Schwartz R, Fortune B, et al. Gastrointestinal and hepatic manifestations of 2019 novel coronavirus disease in a large cohort of infected patients from New York: clinical implications. Gastroenterology. 2020;159(3):1137-40 e2. doi: 10.1053/j.gastro.2020.05.010.
Montazeri M, Maghbouli N, Jamali R, Sharifi A, Pazoki M, Salimzadeh A, et al. Clinical characteristics of COVID-19 patients with gastrointestinal symptoms. Arch Iran Med. 2021;24(2):131-8. doi: 10.34172/aim.2021.21.
Ng SC, Tilg H. COVID-19 and the gastrointestinal tract: more than meets the eye. Gut. 2020;69(6):973-4. doi: 10.1136/gutjnl-2020-321195.
Luo S, Zhang X, Xu H. Don't overlook digestive symptoms in patients with 2019 novel coronavirus disease (COVID-19). Clin Gastroenterol Hepatol. 2020;18(7):1636-7. doi: 10.1016/j.cgh.2020.03.043.
Yang W, Cao Q, Qin L, Wang X, Cheng Z, Pan A, et al. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China. J Infect. 2020;80(4):388-93. doi: 10.1016/j.jinf.2020.02.016.
Pan L, Mu M, Yang P, Sun Y, Wang R, Yan J, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. Am J Gastroenterol. 2020;115(5):766-73. doi: 10.14309/ajg.0000000000000620.
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. doi: 10.1056/NEJMoa2002032.
Liu J, Li S, Liu J, Liang B, Wang X, Wang H, et al. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients. EBioMedicine. 2020;55:102763. doi: 10.1016/j.ebiom.2020.102763.
Cheung KS, Hung IFN, Chan PPY, Lung KC, Tso E, Liu R, et al. Gastrointestinal manifestations of sars-cov-2 infection and virus load in fecal samples from a Hong Kong cohort: systematic review and meta-analysis. Gastroenterology. 2020;159(1):81-95. doi: 10.1053/j.gastro.2020.03.065.
Hashimoto T, Perlot T, Rehman A, Trichereau J, Ishiguro H, Paolino M, et al. ACE2 links amino acid malnutrition to microbial ecology and intestinal inflammation. Nature. 2012;487(7408):477-81. doi: 10.1038/nature11228.
D'Amico F, Baumgart DC, Danese S, Peyrin-Biroulet L. Diarrhea during COVID-19 infection: pathogenesis, epidemiology, prevention, and management. Clin Gastroenterol Hepatol. 2020;18(8):1663-72. doi: 10.1016/j.cgh.2020.04.001.
Redd WD, Zhou JC, Hathorn KE, McCarty TR, Bazarbashi AN, Thompson CC, et al. Prevalence and characteristics of gastrointestinal symptoms in patients with severe acute respiratory syndrome coronavirus 2 infection in the United States: a multicenter cohort study. Gastroenterology. 2020;159(2):765-7 e2. doi: 10.1053/j.gastro.2020.04.045.
Cholankeril G, Podboy A, Aivaliotis VI, Tarlow B, Pham EA, Spencer SP, et al. High prevalence of concurrent gastrointestinal manifestations in patients with severe acute respiratory syndrome coronavirus 2: early experience from California. Gastroenterology. 2020;159(2):775-7. doi: 10.1053/j.gastro.2020.04.008.
Jin X, Lian JS, Hu JH, Gao J, Zheng L, Zhang YM, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut. 2020;69(6):1002-9. doi: 10.1136/gutjnl-2020-320926.
Han C, Duan C, Zhang S, Spiegel B, Shi H, Wang W, et al. Digestive symptoms in COVID-19 patients with mild disease severity: clinical presentation, stool viral RNA testing, and outcomes. Am J Gastroenterol. 2020;115(6):916-23. doi: 10.14309/ajg.0000000000000664.
Nobel YR, Phipps M, Zucker J, Lebwohl B, Wang TC, Sobieszczyk ME, et al. Gastrointestinal symptoms and coronavirus disease 2019: a case-control study from the United States. Gastroenterology. 2020 Jul;159(1):373-375.e2. doi: 10.1053/j.gastro.2020.04.017.
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).