Impact of COVID-19 on digestive system: prevalence, clinical characteristics, outcome, and relation to the severity of COVID-19

Walaa M Hashem; Heba Abdelaziz; Dina E Sallam; Moamen Abdelfadil Ismail; Ahmed Elmetwally Ahmed

doi:10.1186/s43162-022-00132-w

Impact of COVID-19 on digestive system: prevalence, clinical characteristics, outcome, and relation to the severity of COVID-19

Egypt J Intern Med. 2022;34(1):45. doi: 10.1186/s43162-022-00132-w. Epub 2022 May 21.

Authors

Walaa M Hashem¹, Heba Abdelaziz², Dina E Sallam³, Moamen Abdelfadil Ismail⁴, Ahmed Elmetwally Ahmed¹

Affiliations

¹ Gastroenterology, Hepatology and Internal Medicine Department, Ain Shams University, Cairo, Egypt.
² Public Health Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
³ Department of Pediatrics and Pediatric nephrology, Ain Shams University, Cairo, Egypt.
⁴ Internal Medicine Department, Helwan University, Cairo, Egypt.

Abstract

Background: Coronavirus disease 2019 (COVID-19) is commonly associated with respiratory symptoms. However, gastrointestinal (GI) symptoms are increasingly recognized in COVID-19 patients. The aim is to study the prevalence and features of gastrointestinal manifestations in severe acute respiratory coronavirus 2 (SARS-CoV-2) infected patients and evaluate the outcome among the studied population.

Results: We enrolled adult patients with laboratory-confirmed COVID-19 admitted to Ain Shams University designated hospitals, Cairo, Egypt, from March 2021 to June 2021. The patients were assigned to a GI group and a non-GI group based on the presence or absence of one or more digestive symptoms. A total of 300 hospitalized COVID-19 patients were included, of which 104 (34.7%) had one or more digestive symptoms. They were compared with 196 COVID-19 patients without GI symptoms. The most common reported GI symptom was diarrhea (82.7%). GI symptoms' presence was higher in moderate cases. Patients with digestive symptoms presented for care later than those without (7.9±3.8 vs 7.4±7.2 days, P=0.5). Moreover, they have lower mortality, though non-significant (7.7 vs 12.8%, P=0.18). Patients with digestive symptoms had lower total leucocytic count (TLC), neutrophil count, neutrophil to lymphocyte ratio (NLR), platelet count, and higher serum sodium than those without digestive symptoms.

Conclusion: GI symptoms are prevalent among COVID-19 patients, and the most common was diarrhea. The presence of GI manifestations was not associated with increased mortality.

Keywords: COVID-19; Diarrhea; Gastrointestinal symptoms; Mortality; Outcome; Severe acute respiratory syndrome coronavirus 2.