TY - JOUR
T1 - High Prevalence of Gastrointestinal Manifestations of COVID-19 Infection in Hospitalized Patients with Cancer
AU - Grover, Shilpa
AU - Redd, Walker D.
AU - Zhou, Joyce C.
AU - Nije, Cheikh
AU - Wong, Danny
AU - Hathorn, Kelly E.
AU - Mccarty, Thomas R.
AU - Bazarbashi, Ahmad N.
AU - Shen, Lin
AU - Chan, Walter W.
N1 - Funding Information:
Received for publication June 23, 2020; accepted September 24, 2020. From the Departments of *Medicine, Division of Gastroenterology; ‡Medicine, Brigham and Women’s Hospital; and †Harvard Medical School, Boston, MA. This work was funded, at least in part, by the NIH grant T32 DK007533-35. S.G., W.W.C., W.D.R., L.S.: study design; W.D.R., J.C.Z., C.N., D.W., S.G., K.E.H., T.R.M., A.N.B., L.S.: clinical data collection, data analysis; S.G., G.S.R., J.C.Z., D.W., K.E.H., T.R.M., A.N.B., W.W. C.: paper preparation and statistical analysis. S.G. is a gastroenterology editor (employment) at UpToDate, Wolters Kluwer Inc. The remaining authors declare that they have nothing to disclose. Address correspondence to: Shilpa Grover, MD, MPH, Onco-Gastro-enterology Program, Division of Gastroenterology, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115 (e-mail: [email protected]). Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/MCG.0000000000001462
Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/1
Y1 - 2021/1
N2 - Background and Aim:Gastrointestinal (GI) symptoms have been reported with SARS-CoV-2 infection, but data on the prevalence and severity of GI symptoms in patients with cancer are limited. We sought to characterize the GI manifestations of coronavirus disease-19 (COVID-19) in oncology patients.Materials and Methods:We performed a multicenter cohort study of adult patients hospitalized with COVID-19 in 9 Massachusetts medical centers and identified those with an active malignancy. We evaluated the prevalence and severity of GI symptoms among hospitalized COVID-19 patients with cancer.Results:Of 395 hospitalized patients with COVID-19, 36 (9%) had an active malignancy. Of the 36 cancer patients, 23 (63%) reported ≥1 new GI symptom. The most prevalent symptoms were anorexia (12, 52%), diarrhea (9, 39%), and vomiting (8, 35%). GI symptoms were the initial symptom in 4/36 (11%) patients, were the predominant symptom in 5/36 (14%) patients, and were severe in 4/23 (17%) patients. Four of 5 patients with GI symptoms at presentation reported concurrent fever; notably 1 patient had no fever or respiratory symptoms. Twelve (33%) patients had elevations in liver transaminases at presentation; patients with elevated transaminases were more likely to have associated GI symptoms (83% vs. 54%, P=0.04).Conclusions:Acute GI symptoms associated with COVID-19 are highly prevalent in hospitalized cancer patients and can occur as a presenting symptom without respiratory symptoms. Symptoms are severe in a small subset of patients.
AB - Background and Aim:Gastrointestinal (GI) symptoms have been reported with SARS-CoV-2 infection, but data on the prevalence and severity of GI symptoms in patients with cancer are limited. We sought to characterize the GI manifestations of coronavirus disease-19 (COVID-19) in oncology patients.Materials and Methods:We performed a multicenter cohort study of adult patients hospitalized with COVID-19 in 9 Massachusetts medical centers and identified those with an active malignancy. We evaluated the prevalence and severity of GI symptoms among hospitalized COVID-19 patients with cancer.Results:Of 395 hospitalized patients with COVID-19, 36 (9%) had an active malignancy. Of the 36 cancer patients, 23 (63%) reported ≥1 new GI symptom. The most prevalent symptoms were anorexia (12, 52%), diarrhea (9, 39%), and vomiting (8, 35%). GI symptoms were the initial symptom in 4/36 (11%) patients, were the predominant symptom in 5/36 (14%) patients, and were severe in 4/23 (17%) patients. Four of 5 patients with GI symptoms at presentation reported concurrent fever; notably 1 patient had no fever or respiratory symptoms. Twelve (33%) patients had elevations in liver transaminases at presentation; patients with elevated transaminases were more likely to have associated GI symptoms (83% vs. 54%, P=0.04).Conclusions:Acute GI symptoms associated with COVID-19 are highly prevalent in hospitalized cancer patients and can occur as a presenting symptom without respiratory symptoms. Symptoms are severe in a small subset of patients.
KW - COVID-19
KW - SARS-CoV-2
KW - cancer
KW - diarrhea
KW - elevated liver tests
KW - gastrointestinal symptoms
KW - transaminase elevations
UR - http://www.scopus.com/inward/record.url?scp=85097210708&partnerID=8YFLogxK
U2 - 10.1097/MCG.0000000000001462
DO - 10.1097/MCG.0000000000001462
M3 - Article
C2 - 33116066
AN - SCOPUS:85097210708
SN - 0192-0790
VL - 55
SP - 84
EP - 87
JO - Journal of Clinical Gastroenterology
JF - Journal of Clinical Gastroenterology
IS - 1
ER -