GI Symptoms Association with Disease Severity

73 views 0 04/01/2020 05/10/2020

  1. Diarrhea, vomiting, and nausea are symptoms identified in 11,4 % of patients.1
  2. A study done in China demonstrated that patients with GI symptoms had a more severe case based on symptoms, radiologic aspect and laboratory results.1
  3. Another study, done in Zhuhai (China), demonstrated that the presence of SARS-CoV-2 RNA in feces does not necessarily correlate with more severe GI symptoms.2
  4. A pooled analysis done by Italian researches demonstrated abdominal pain was found to be associated with four times increased odds of severe COVID-19. Thereby, the authors suggest that abdominal ache may be a sign of severity due to an increase of viral replication in the gut and may be used as a clinical predictor of a more severe case.3
  5. Some patients with GI symptoms (32.6%) developed hepatic function impairment during hospitalization with elevated bilirubin and transaminases.2
  6. The ratio cases with GI symptoms was higher in patients with chronic liver disease and other liver diseases.1
  7. Antibiotic treatment was associated with diarrhea as well as elevated bilirubin levels during hospitalization. However, antiviral treatment did not exert such effects. Thereby, GI symptoms in COVID-19 patients might be due to antibiotics.2
  8. Higher family clustering was also identified in patients with GI symptoms.1

 

This data comes from multiple sources:

  1. This article was done at Zhejiang University, China. The data were collected from 17 January 2020 to 8 February 2020. Xi Jin and al. collected data of 651 patients which had 74 patients (11.4%) that presented with at least one GI symptom (Diarrhea, vomiting, or/and nausea). The article studied non-classical symptoms such as GI symptoms expressed by patients who tested positive for SARS-CoV-2.
  2. This is a single-center study reviewed data from 95 COVID-19 positive patients. from 17 January to 15 February 2020, at the Fifth Affiliated Hospital of Sun Yat-sen University in Zhuhai, China.
  3. This editorial was done by an Italian COVID-19 research team. They searched on Medline and the Chinese National China National Knowledge Infrastructure (CNKI) using keywords such as nausea, abdominal pain, vomiting, and diarrhea. They then performed a pooled analysis to draw a conclusion.

 

Source:

  1. Jin, X., Lian, J.-S., Hu, J.-H., Gao, J., Zheng, L., Zhang, Y.-M. and al. (2020). Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut. DOI: 10.1136/gutjnl-2020-320926
  2. Lin, L., Jiang, X., Zhang, Z., Huang, S., Zhang, Z., Fang, Z., … Shan, H. (2020). Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection. Gut, 69(6), 997–1001. DOI: 10.1136/gutjnl-2020-321013
  3. Henry, B. M., Oliveira, M. H. S. D., Benoit, J., & Lippi, G. (2020). Gastrointestinal symptoms associated with severity of coronavirus disease 2019 (COVID-19): a pooled analysis. Internal and Emergency Medicine. DOI: 10.1007/s11739-020-02329-9
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