TY - JOUR
T1 - Digestive Manifestations in Patients Hospitalized With Coronavirus Disease 2019
AU - North American Alliance for the Study of Digestive Manifestations of COVID-19
AU - Elmunzer, B. Joseph
AU - Spitzer, Rebecca L.
AU - Foster, Lydia D.
AU - Merchant, Ambreen A.
AU - Howard, Eric F.
AU - Patel, Vaishali A.
AU - West, Mary K.
AU - Qayed, Emad
AU - Nustas, Rosemary
AU - Zakaria, Ali
AU - Piper, Marc S.
AU - Taylor, Jason R.
AU - Jaza, Lujain
AU - Forbes, Nauzer
AU - Chau, Millie
AU - Lara, Luis F.
AU - Papachristou, Georgios I.
AU - Volk, Michael L.
AU - Hilson, Liam G.
AU - Zhou, Selena
AU - Kushnir, Vladimir M.
AU - Lenyo, Alexandria M.
AU - McLeod, Caroline G.
AU - Amin, Sunil
AU - Kuftinec, Gabriela N.
AU - Yadav, Dhiraj
AU - Fox, Charlie
AU - Kolb, Jennifer M.
AU - Pawa, Swati
AU - Pawa, Rishi
AU - Canakis, Andrew
AU - Huang, Christopher
AU - Jamil, Laith H.
AU - Aneese, Andrew M.
AU - Glamour, Benita K.
AU - Smith, Zachary L.
AU - Hanley, Katherine A.
AU - Wood, Jordan
AU - Patel, Harsh K.
AU - Shah, Janak N.
AU - Agarunov, Emil
AU - Sethi, Amrita
AU - Fogel, Evan L.
AU - McNulty, Gail
AU - Haseeb, Abdul
AU - Trieu, Judy A.
AU - Dixon, Rebekah E.
AU - Yang, Jeong Yun
AU - Mendelsohn, Robin B.
AU - Calo, Delia
N1 - Publisher Copyright:
© 2021 AGA Institute
PY - 2021/7
Y1 - 2021/7
N2 - 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.
AB - 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.
KW - COVID-19
KW - Digestive Manifestations
KW - Gastrointestinal Symptoms
KW - Hepatic Manifestations
KW - SARS-CoV-2
UR - http://www.scopus.com/inward/record.url?scp=85101865891&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2020.09.041
DO - 10.1016/j.cgh.2020.09.041
M3 - Article
C2 - 33010411
AN - SCOPUS:85101865891
SN - 1542-3565
VL - 19
SP - 1355-1365.e4
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 7
ER -